SECT. XCXIV.—ON THE SCAPULA.
The scapula is not fractured in its broad and tabular part, but a fracture may sometimes take place at its spine. The fracture being sometimes what is called by expression, sometimes a simple fracture, and sometimes a piece is broken off. The expression, then, is ascertained by the touch, exhibiting a hollow, and occasioning torpidity of the adjacent arm and a throbbing pain. Simple fracture is known by its roughness and local pain. Both are to be managed according to the anti-inflammatory plan of treatment. When a piece is broken off, which also may be ascertained by the touch, if it gives no disturbance it may be fixed by a convenient bandage, but when it moves about and produces irritation, it is to be removed by an incision, and sutures used, as described above. Bandages like those for the clavicle are to be applied, and the patient is to be laid on the opposite side.
Commentary. Hippocrates has not treated particularly of this fracture.
Celsus treats in general terms of the cheek-bone, breast-bone, the broad bone of the scapula, the spine, os sacrum, &c. If there be an external wound, it is to be healed with suitable dressings; after which the fissure or hole in the bone will fill up with callus. If the skin be entire, he merely enjoins rest, a suitable cerate, and gentle bandages.
Albucasis and Avicenna, as usual, copy from our author. The former states that fractures of the scapula are healed in twenty or twenty-five days. Haly Abbas, like the others, directs us to remove any spiculæ which occasion irritation, to apply soothing cataplasms, and suitable bandages. Rhases remarks that the body of the bone is little subject to fractures, but that its extremities may be broken off. A fracture of the hollow portion of it is ascertained by a rising in the part; fissures are recognized only by the local pain.