Subcutaneous nailing, exploratory incision, and the extended elbow in condyloid fractures of the humerus / by John B. Roberts.

  • Roberts, John B. (John Bingham), 1852-1924.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Subcutaneous nailing, exploratory incision, and the extended elbow in condyloid fractures of the humerus / by John B. Roberts. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    11/24 (page 7)
    resulting from fractures of the condyloid portion of the humerus are doubtless due, not only to incomplete reduction of the broken bone, but to imperfect fixa- tion, which has allowed the properly readjusted frag- ments to slip again into abnormal relations. Stimson is, probably, not alone in his belief^ that, in inter- condyloid fracture with marked separation, there is no practicable means surely to maintain reduction. He says, further, that the impossibility of direct control of the fragments, the contraction of muscles, and the press- ure of fascia combine to make the result largely a mat- ter of chance. This opinion was confirmed, he states, by seeing and feeling in open fractures the difl&culty caused by the shiftings of the fragments. I have been making some experimental observations during recent months on the use of nails for direct fixa- tion of fractures, having been led to the investigation by my success at the Philadelphia Polyclinic Hospital in nailing together the fragments of a metacarpal bone. I have found that fractures of the condyles of the hu- merus, made in the cadaver, can be satisfactorily fixed after reduction, by driving wire nails through the skin into the bone and across the lines of separation. The accompanying skiagraphs show the method bet- ter than a verbal description. I became convinced by this experimental work of the efficiency of fixation by means of slender nails, and of the wisdom of adopting the procedure in the com- paratively few severe fractures of the humeral condyles needing direct fixation. I have had, however, no per- sonal clinical experience of such operative treatment in elbow-injuries, and my opinion was based on induc- tive reasoning alone and the use of similar means in resection and osteotomy. A few days ago I came upon Stimson's statement that