Colles's fracture, with special reference to the results of the different modes of treatment : being a synopsis of the Hutchinson triennial prize essay, 1908 / by H. Emlyn Jones.

  • Jones, H. Emlyn.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Colles's fracture, with special reference to the results of the different modes of treatment : being a synopsis of the Hutchinson triennial prize essay, 1908 / by H. Emlyn Jones. 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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    Cte, OeJ l Q 0% “COLLES’S FRACTURE, WITH SPECIAL REFERENCE TO THE RESULTS OR ^-DIFFERENT MODES OF TREATMENt| B'iA2i wfis I' THE HUTCHINSON TRIENNIAL PRyfe ESSAY, 1908, ■jy sT^ H. EMLYN JONES PART 1. After introducing and defining the subject, the author proceeds to give an outline of the history of Colies’s Fracture from the time it was first des- cribed by Pouteau in 1783 until the present time. The following writers’ works and opinions were discussed at length :— 1. Pouteau (1783). 2. Colies (1819), who really published the first decent account of the fracture. 3. Dupuytren (1820), who, by a post-mortem examination, showed the real character of the injury. 4. Voillemier (1842), who held this fracture to be alwa^ s one of penetration. 5. Smith (1847), who opposed Voihemier’s views. 6. Bennett (1879), who, from many recent dissections, first advocated the view that both “impaction” and “non- impaction” may occur. The author then proceeds to show how in recent years, chiefly by the aid of radiography, we have ample proof that the simple transverse fracture without impaction, the impacted, and the fracture with the shattered lower fragment, together with many greater or lesser complications, may occur. The Rbntgen rays have added more to our know- ledge of the details of the injury than any other means, showing that the surface of the fracture is rarely flat and transverse, that comminution or splitting of the lower fragment is frequent, and especially that the displacement backwards of this fragment is not nearly so commonly marked as one would suppose from the general appearance of the wrist. SL The typical deformity and position of fragments in a Colies’s Fracture, showing the most common displace- ment met wiih. [After “ Helferich. Ed. by J. Hutchinson, Junr.~\ Regarding the mechanism by which the fracture is produced, three chief theories have been advanced:— (1) Fracture by splitting or crushing; the cancellous tissue is crushed or com- minuted between the carpus and the diaphysis. (2) Fracture, as in other bones, by resolu- lution of the force and yielding at the weakest point. (3) Fracture by cross-strain exerted through the anterior ligament in exaggerated and forced hyper-extension of the hand. In 1 the weight of the body is received upon the ball of the hand, in the line of the long axis of the radius, the inner end of the scaphoid or the semi-lunar splits the end of the radius like a wedge. This is seen in many cases, and appears to be the more frequent in the elderly. A