180 SURGICAL APPLIED ANATOMY. [Chap. xi. 



to it, the displacement is usually slight, inasmuch as 

 the coraco - clavicular ligaments are seldom torn. 

 These ligaments, it may be noted, are attached to the 

 base of the process. In some few cases the process 

 has been torn off by muscular violence. 



Among the more usual fractures of the body of the 

 scapula is a transverse or oblique fracture of its blade 

 below the spine. Owing to the infraspinatus, sub- 

 scapularis, and other muscles being attached to both 

 fragments, none but a trifling displacement is usual. 

 A fracture may occur through the surgical neck. The 

 surgical neck is represented by a narrowed part 

 of the bone behind the glenoid fossa, and in the 

 line of the suprascapular notch. The smaller frag- 

 ment will, therefore, include the coracoid process, 

 the larger, the acromion. The amount of deformity 

 in these cases depends upon whether the coraco- 

 clavicular and acromio-clavicular ligaments are entire 

 or torn. If they be torn, the small fragments and 

 the entire limb are displaced downwards, and the 

 injury somewhat resembles a subglenoid dislocation. 

 From this, however, it is distinguished by the 

 crepitus, by the ease with which the deformity is 

 removed and the equal ease with which it returns, 

 by the position of the head of the humerus in regard 

 to the glenoid fossa, and by the conspicuous fact that 

 the coracoid process is displaced downwards with the 

 limb. 



Tumours of various kinds grow from the scapula 

 and mainly from the spongv parts of the bone, viz., 

 the spine, the neck, the inferior angle. The bone 

 may be removed entire, with or without amputa- 

 tion of the upper limb. The main vessels to be noted 

 in connection with this operation are the supra- 

 scapular at the superior border of the bone, the 

 posterior scapular about the vertebral border, the 

 subscapular running along the lower border of the 



