242 



APPLIED ANATOMY. 



has been destroyed and its prop-like action lost, its function of abduction ceases, and 

 the patient is unable properly to elevate the arm. Sometimes the brachial plexus or 

 subclavian vessels are injured by the inner end of the outer fragment. The artery 

 passes beneath the middle of the bone, the vein being to its inner side and the 



Trapezius 



Corac 



Deltoid 



ivicular fibres 

 sternomastoid 



Brachial plexus 

 - Subclavian vessels 



Pectoralis minor 



Pectoralis major 



FIG. 257. Fracture of the clavicle just outside the middle. The outer fragment is displaced downward and 

 inward and the inner fragment upward. The brachial plexus and subclavian vessels are behind the inner end of 

 the outer fragment. 



brachial plexus to its outer side. We have operated on one such case of injury to 

 the brachial plexus; and cases of haematoma arising from injury to the veins and 

 aneurism from injury to the artery have been recorded. 



Treatment. When the line of fracture is oblique and in an adult, healing with a 

 certain, often considerable, amount of deformity is almost constant, the only efficient 



FIG. 258. Showing how the shoulder falls inward and the posterior edge of the scapula tilts outward when the 

 prop-like action of the clavicle is destroyed by fracture. 



way of combating its occurrence is to place the patient in bed on his back. This is the 

 best way of removing the weight of the arm, of quieting the muscles, and by pressure 

 of the scapula close to the thorax of levering the shoulder out (see Fig. 258). 



