Remarks upon fractures of the scapula, with cases presenting striking peculiarities : read before the Medical Society of the State of Georgia, at their annual meeting in Augusta, April 8, 1857 / by L.A. Dugas.

  • Dugas, L. A. (Louis Alexander), 1806-1884.
Date:
1857
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Licence: Public Domain Mark

Credit: Remarks upon fractures of the scapula, with cases presenting striking peculiarities : read before the Medical Society of the State of Georgia, at their annual meeting in Augusta, April 8, 1857 / by L.A. Dugas. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    sling to be placed under the elbow in such a manner as to bring this close to the chest and slightly forwards, at the game time that the force be so directed as to carry the shoulder upwards and a little outwards. By attaching to the ends of the sling slips of bandage, these may be carried around the thorax and arm , to prevent any motion of the limb. This apparatus is much tin- same as that I usually apply for fractures of the clavicle, with the single exception that the elbow should not be carried so far for- wards in fractures of the scapula. Fractures of the spine of the scapula may accompany those of the body of the bone, or may exist independently of these. Malgaignc (T. 1, p. 499) says, that he knows of no instance in which the spine alone has been broken. Yet they arc mentioned by Paulus Egineta, Ambrose Tare, and modern writers of distinction. By endeavoring to iix the scapula while motion is imparted to the spine through the acromion process, or by more direct manipula- tion, crepitation may be usually produced. In some cases the prominenee of the spine will be diminished more or less consider- ably; but the tumefaction, which soon ensues, may prevent this from being apparent. I need scarcely add, that the treatment of such cases should be similar to that recommended for fractures of the body of the bone, properly so called. Fractures of the Acromion Process.—The acromion is generally thought to be more frequently broken than any other portion of the scapula. Such is not the result of my observation, for out of the four cases of fracture of this bone which I have seen in my private practice, this process was found to be broken only once. According to the statistics above referred to, the acromion was fractured in eight out of eighteen cases of injury of the scapula. Malgaigne thinks the accident not so common as fractures of the body of the scapula. Yet, from its superficial and exposed posi- tion, it wouldseem to be natural that it should be more frequently injured than any other portion of the bone. The acromion may be fractured at any point, from its extremity to its connexion with the spine of the scapula; and although the fracture is usually transverse., it may be more or less oblique. The extent of displacement will vary according to the seat and com- pleteness of the fracture. If this be near the extremity, and espe- cially if the periosteum be but slightly torn, there may be very