The Region of the Elbow. 69 



the above symptoms, increased breadth of the elbow 

 joint, and crepitation elicited by pressing the condyles 

 together from side to side. The diagnosis of supracond- 

 yloid fracture, from dislocation of both bones backwards, 

 is discussed on page 71. In the consideration of fractures 

 about the elbow joint it is necessary 'to distinguish be- 

 tween the terms condyle and epicondyle the former 

 (condyle) includes not only the projection outside the 

 joint, but a portion of the articular surface as well, 

 whereas, the latter (epicondyle) means that portion, only, 

 of the humerus outside the joint. 



Zuckerkandl has shown that the projection, termed 

 epicondyle, is composed, partly of an epiphysis, and partly 

 of a portion of the humerus itself on which the epiphysis 

 rests, hence, in an injury to this region producing a frac- 

 ture of the epicondyle, in a patient under the age of 18, it is 

 possible that it is the epiphysis that has become separated, 

 whereas, in the adult, it is probably a fracture involving 

 the epiphysis itself as well as a portion of the humerus 

 outside of the joint. 



The epiphyseal line of the lower extremity of the 

 humerus may be roughly indicated by a line drawn across 

 immediately above the two epicondyles. Fractures in the 

 neighborhood of the elbow joint are very common in 

 childhood, and the bones entering into the formation of the 

 joint fit one another so accurately, that the presence of a 

 small amount of callus, or, the slightest displacement of the 

 component parts of the joint, may seriously interfere with 

 its proper function. It is therefore advisable to inform the 

 parents of the child of the possibility of impaired action 

 of the joint resulting from the fracture. When the inter- 

 nal condyle is displaced upwards and unites in that posi- 

 tion, the ' 'carrying angle" spoken of above, is altered 

 and the outer portion of the elbow projects, resulting in 

 what Allis terms "gunstock" deformity. 



