Albucasis says that the fore-arm is dislocated in all directions, but more especially backwards and forwards. His description of the mode of reduction is evidently copied from Paulus. Avicenna likewise borrows his whole account from our author.
Rhases and Haly Abbas describe the ordinary cases of complete luxation at the elbow-joint, but we believe that neither they nor any of the Arabians take notice of the dislocation of the radius from the ulna, nor the abruption of the apophysis of the humerus.
SECT. CXVI.—ON DISLOCATIONS AT THE WRIST AND FINGERS.
Dislocations at the wrist and fingers are attended with no difficulty, unless accompanied with a wound. This case, therefore, will be treated of under the head of dislocations with a wound. Those without a wound may be remedied by moderate extension and the anti-inflammatory plan of treatment.
Commentary. Hippocrates says that the hand is dislocated inwards and outwards, but most frequently inwards. In the former case it is found impossible to bend the fingers, and in the latter to extend them. He also makes mention of dislocations to either side. He directs us to make counter-extension upon a table, and to push down the projecting end of the bone with the hand or the heel. He also describes the separate dislocation of the radius and ulna; and, upon the whole, his account is very little different from that given by Sir Astley Cooper in his ‘Lectures,’ and by Mr. Liston in his ‘Elements of Surgery.’
Celsus describes, in his usual elegant manner, the dislocations forwards and backwards. He denies the possibility of the lateral dislocations, and, in fact, it is now acknowledged that if ever they do occur they are incomplete. Like Hippocrates, he directs us to replace dislocations of the fingers by making extension upon a table. He does not make mention of the separate dislocation of the lower end of the radius.
Oribasius mentions the dislocations forwards and backwards, and likewise the separate dislocations of the radius and ulna. Sometimes, he says, the radius is dislocated, while the ulna remains in its place, and sometimes the ulna is dislocated while the radius remains. He describes the process of reduction with machines.
Albucasis, Avicenna, and Haly Abbas describe very accurately the dislocations forwards and backwards. They state that immediate reduction is peculiarly required in the case of this accident. Avicenna recommends a strengthening plaster to be put on the part before the splints are applied. When the joint, after reduction, is found to have lost the power of motion, Albucasis recommends us to pour hot water upon it and apply friction.
Rhases states that the ulna is more apt to be dislocated separately than the radius, which generally undergoes fracture rather than luxation. The fingers, he says, are mostly dislocated inwards.