File:Buffalo medical journal (1913) (14577359510).jpg

Identifier: buffalomedicaljo6919unse (find matches)
Title: Buffalo medical journal
Year: 1914 (1910s)
Authors:
Subjects: Medicine
Publisher: Buffalo, N.Y. : (s.n.)
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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at of injury follow-ing cases of dislocation or fracture in which the dislocation orfracture has been adjusted satisfactorily, but in which the pa-tient complains of pain on pressure over the area of the bursa orin certain motions of the arm. Anatomically, the bursa variesconsiderably, sometimes very small and again very large, so thatwhen injured its function is not properly maintained and themechanism of the shoulder is naturally impaired. This is espe-cially true when there is a predisposing diathesis. When the MEISENBACH : ORTHOPEDIC CONDITIONS 411 subdeltoid bursa is involved, a person is usually able to raise thearm over the head and in many directions, but the motion ispainful, as the two walls of the bursa are usually adherent andmay be thickened so that when the person raises the arm beyondthe shoulder the bursa has difficulty in passing under the acromionprocess. In locating this bursa, and especially in subdeltoidbursitis, Dawbarns sign is very helpful. With the arm hanging
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RUPTURE OP THE SUPRASPINATUS MUSCLE OF THE LEFT ARM. Figure shows patient attempting to raise both arms and using all possible strength.Can raise right arm but not the left. a. —Limited action of the deltoid, with rupture of supraspinatus muscle. b. —Action of the deltoid and the supraspinatus muscles together.(Amputation of right arm does not enter into present condition of the patient, but was probably a factor in producing rupture of the supraspinatus muscle of the left arm byover-use of the left arm.) down, pressure over the site of the bursa will elicit pain, whereas,when the arm is raised up to the level of the shoulder, pressureover the same anatomical landmark will not elicit pain, the bursahaving glided under the acromion process by the elevation of thearm. In fracture or dislocation of the shoulder the bursa may beinjured and convalescence may be retarded to many months ifthe condition is not observed, and the retardation may be creditedto an improper replacement of the

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