1522 



WRIST-JOINT (ABNORMAL ANATOMY). 



the dorsal prominence to the root of the in- inch over that of the opposite hand. This 

 dex finger (from A to B fig. 93-k), on the in- excess of length was manifestly caused by 

 jurcd side, gave an excess of length of half an the presence of the disjoined epiphysis, which 



Fig. 934. 



Disjunction of the Epiphysis of the Radius, with displacement backwards of the Hand and Carpus, 



Author's Collection. 



had been superadded to the summit of the 

 carpus, and was carried back with it, the 

 wrist-joint itself remaining perfect. 



This simple test of the comparative measure- 

 ment proved the case was not one of mere 

 dislocation of the hand ; but we may also add, 

 that, although there was considerable swelling 

 and projection forwards of the palmar surface 

 of the region of the wrist, there were not 

 those hard protuberances to be felt in front of 

 the carpus which the extremity of the radius 

 and ulna, with their styloid processes, should 

 have presented had the dislocation above 

 alluded to occurred. 



The man died, in a few hours after admis- 

 sion, from the injuries he received, particularly 

 of the head. 



It had not been deemed advisable to reduce 

 the fracture, as the man seemed to be in a 

 dying state. 



Dissection. With the assistance of my 

 friend, Dr. Power (now Professor of Anatomy 

 of the Royal College of Surgeons, Dublin), I 

 removed the greater part of the forearm, that 

 we might the more carefully examine the 

 true nature of the lesion, the external ap- 

 pearances of which we have above described. 



On making, then, the anatomical examina- 

 tion of the parts composing the region of the 

 wrist in this case the radius was found to 

 have suffered a transverse interruption of con- 

 tinuity in the line of junction of its inferior 

 epiphysis, and the lower fragment was dis- 

 placed directly backwards, so far as nearly to 

 have passed the extremity of the upper frag- 

 ment (fg. 935.). The lower extremity of the 

 ulna was broken a short distance above the line 

 of junction with its epiphysis. This fracture 

 was oblique. The extremities of the two frag- 

 ments of the ulna formed with each other an 

 angle salient in front. The ligaments and the 

 radio-carpal articulation also remained unin- 

 jured, and the carpus (of course) accompanied 

 the lower fragment of the radius in its dis- 

 placement backwards. 



CASE 4. A bo\\ set. eleven, was admitted 

 into the Richmond Hospital on the 2nd of 

 September, 1840, under the care of Dr. Mac- 

 donnell. Upon the Sunday previous to his 



admission he had been thrown from a horse 

 with great violence. The lower extremity of 

 the left radius was broken, and he sustained a 



Fig. 935. 



Din/unction of the Lower Epiphysis of the Radius, 

 li-ith fracture of the Ulna, and displacement back- 

 wards of the Carpus and Hand. Museum of the 

 Richmond Hospital. 



concussion of the brain, under the influence 

 of which he remained insensible for three 

 quarters of an hour. The accident occurred 

 at some distance from town. Before an hour 

 elapsed the boy was visited by a surgeon, who, 

 it is said, forcibly extended the limb, and then 

 applied a narrow roller tightly round the wrist. 

 On the following day (Monday) the patient 



