[10] For a very important improvement made by Dr. Physic in the
treatment of an old fracture of the os humeri, and which may be
applied also to similar fractures of other bones, see Article I. of
the Appendix. TRANS.
1. The language of the surgeon differs, in this case, from that of
the anatomist, and by the expression, “fracture of the neck of the
humerus,” is here meant not that of the slight circular depression,
which separates the head from the tuberosities of the bone, but rather
that of the contracted or diminished portion of the bone, which
commences at the tuberosities above, and being continued down the body
of the bone, receives at its lower end the insertion of the tendons of
the pectoralis major, the latissimus dorsi, and the teres major. Many
practitioners consider this neck or contracted portion as extending
even to the insertion of the deltoid muscle.
2. Several facts, the truth of which it is difficult to call in
question, attest the possibility of a fracture of the neck of the bone,
so called in anatomical language. I have myself seen, in the humerus
of a young man, aged seventeen years, the head of the bone exactly
separated from its body, by a division which had but slightly affected
the upper extremity of the tuberosities. But the examples of this
nature which occur in the annals of surgery are too few, to enable us
to lay down any general principles for the treatment of such fractures.
§ II.