An essay upon the original or congenital luxations of the upper extremity of the humerus / by Robert William Smith.

  • Smith, Robert William, 1807-1873.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: An essay upon the original or congenital luxations of the upper extremity of the humerus / by Robert William Smith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    gens de Tart de graves erreiirs de jngement, et aux malades dcs traitemens anssi inutiles qu’ils sont rigoreux.” I have observed within the last few years, and ascertained by post mortem examination, the existence of two varieties of congenital luxation of the head of the humerus, and I am of opinion that these deviations from the normal state of the bones of the shoulder joint, (though existing from the earliest period of life,) may not develope themselves, so as to attract attention in a decided manner for many years; this position, applied to the ileo-femoral articulation, we at once admit. Dupuytren has, with much clearness, shown that the original luxation of the head of the femur may pass unnoticed in the infant, or if I observed be ascribed to a cause different from the true one ; but when the pelvis, begins to increase in breadth, and the child is subjected to longer and more fatiguing exertions, then the j characteristic features of the original malformation become J apparent, and when the pelvis is fully developed, and all parts have completed their growth, and are called into action, the \ nature of the affection can.no longer be doubted or mistaken ; ^ the same observations apply, though not perhaps with equal j force, to the analogous condition of the shoulder joint. In early life, before the bones have reached their due development, before the muscles which play upon the articulation are called to their full exertion, the outward signs of the deformity may possibly escape observation ; but when the bones of the shoul- der have reached maturity, when the osseous prominences which overhang the joint stand out in full relief, and particularly when the muscles which act upon the articulation and upon the arm, are called upon to execute their office, then is it that the characteristic features of the original luxation become strikingly apparent. The two varieties of congenital dislocation of the head of the humerus, which have fallen under my observation, may be termed subcoracoid and subacromial; of the former species T • have seen three examples, of the latter but one.