64 THE SUPERIOR EXTREMITY 



and it is difficult to treat owing to the lack of fixation of the 

 head (p. 53); which may become a loose body in the elbow-joint. 

 On pronation and supination, the head of the radius does not 

 rotate in the annular ligament,, and the muscles are thrown into 

 spasm. Owing to non-union or to faulty union, movements of 

 the elbow may be so restricted that excision of the head of the 



FIG. 23. Elbow of an Adult Male, showing a Fracture of the Olecranon, 

 wired in Two Planes. Note that the wires do not invade the joint cavity. 



bone is rendered necessary. It may be approached by a 

 longitudinal incision over the interval between the anconaeus 

 and the extensor carpi ulnaris (Fig. 26). 



Many of the fractures in this region are both intra- and 

 extra-capsular, and the haemorrhage and effusion into the joint 

 render their diagnosis difficult, even with the assistance of the 

 X-rays. 



Surgical Approach to the Elbow- Joint. Kocher's lateral 



