The bones, here shown, have an extraordinary appearance.
The articulating ends are all greatly enlarged, spongy and
light. The humerus of the right elbow has lost all traces of its
original characters ; the fossae before and behind are filled up
with bone ; interiorly, the part representing the inner condyle
descends an inch and a half lower than that on the outside.
The sigmoid cavity of the ulna is converted, by long project-
ing growths from the olecranon and coronoid, into a great bed,
on which the humerus lies, mechanically locked, without the
possibility of motion. The head of the radius is rendered
equally [immoveable by enlargement and disfiguration. The
tendency most predominant in this affection, was that towards
exuberancy of osseous deposits; and even after all painful or
inflammatory action had subsided, such deposition appears to
have been continued—thrusting forth bony tuberosities and
spicula into every crevice which afforded an unresisting locality
for them. The left elbow, as far as regards the changes
in the bones, is wonderfully like the preceding—with this exception,
that though the disease had been of shorter standing,
the bones are larger and more disfigured, but without such
mechanical interlocking of the new growths, which may account
for the greater mobility of the joint : they lie together
in mis-shapen masses—the bare bones in mutual contact, rubbing
and grating against each other at every forced movement.
The disease affecting each joint was the same ; and its consequences
in both have been alike unusual. Had not the patient
been so unexpectedly carried off, the left elbow, would,
no doubt, have been fined down to the same tolerable condition
as the right, and he might have convalesced. He
should, however, have continued, ever after, a burthen to himself
and his friends ; for the form of the members (see drawing)
had become such as to render them useless even for the
necessary purposes of conveying food to the mouth.—Doctor
Houston.
E. b. 948b Drawing of the trunk and both arms of the
above individual, taken during his stay in the hospital, and before
being seized by his last fatal illness. The form and fixed
position of the diseased members are well shown.—Idem.
E. b. 950. Old, unreduced dislocation of the elbow of a female,
accompanied with fracture of the external condyle of
the humerus. The joint is extended, but admitted of flexure
to nearly a right angle, by the application of some force : it
is, also, much bent outwards. The lower end of the humerus
is much disfigured, partly from the changes produced, immediately,
by the accident; and partly, as the slow result of the
altered relations of the bones to each other, and of the new
motions which they had become subjected to.
When the humerus is looked at, as a whole, the internal
condyle and trochlear articulation may be seen to lie in the
position natural to them, though somewhat changed in shape,
but the outer condyle, with the socket for the head of the
radius, is thrown behind the trochlea, and raised about three-
fourths of an inch above it. An oblique prominent line on
the front, marks the seat of a long-healed fracture, which had
detached this part of the bone at some former period of life.
The olecranon process lies against the upper part of the depression
for its reception in the humerus; the coronoid, of
which however but little remains, has formed for itself a bed
on the back part of the trochlea of the humerus. From the
coronoid, downwards, there is a flat, triangular plane, which,
in attempts at flexion, may be brought successively into contact
with the different parts of the trochlear articulation.
The radius retains its original connection with the displaced
external condyle, and also with the lesser sigmoid cavity of
the idna, in the displacement of which it participated. Rotatory
motion towards pronation was free beyond what is natural
; and such was the position assumed by the member when
unrestrained. Perfect supination was impossible. There is