Image from page 893 of “The practice of surgery” (1910)

Image from page 893 of "The practice of surgery" (1910)
Hand Wrist Pain
Identifier: practiceofsurger00mumf
Title: The practice of surgery
Year: 1910 (1910s)
Authors: Mumford, James Gregory, 1863-1914
Subjects: Surgery
Publisher: Philadelphia and London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
ig. 578.—Colles fracture. Crowding the fragments together for diagnosis. point where the radial styloid joins the shaft. One should put thepatient through the normal movements of the hands, wrist, and arm,flexion, extension, and rotation. Then we observe the abnormalities of the damaged arm; the wristappears unnatural; in extreme cases we may see at once the familiarsilver-fork deformity; the thenar eminence is higher and nearer tothe wrist than normal. The whole hand is somewhat abducted andthe styloid process of the radius is no longer found on a level lower than 888 MINOR SURGERY—DISEASES OF STRUCTURK the styloid of the uhia, but at the same level or at a higher level even.Sometimes the ulnar styloiil is fractured, in Avhich case the i-elation ofthese two points appears normal. One may often elicit pain lv palpating the end of the radius. Incase of a doubtful fracture^ an excellent test is to seize the patientshand, and, while supporting his arm above, to crowd the hand gently

Text Appearing After Image:
Fig. 579.—Dorsal dislocation of the wrist. Note deformity at wrist-joint—neitherabove nor below it (after Helferich) (Scudder). upward. This invariably will bring out a point of pain near the lowerend of the radius if a fracture exists. If there be a sprain merely,this crowding upward of the hand gives relief rather than pain. InColles fracture the fragments may be impacted or may be loose; andthe exact condition of the radius, as well as of the other bones aboutthe wrist, is faithfully demonstrated by the x-ra3^

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