T-shaped fracture of lower epiphysis of humerus.
Fig. 291
Intracondyloid fracture of humerus. Almost perfect functional result. (Parmenter.)
Fig. 292
Gunstock deformity after fracture of internal condyle, illustrating neglect of precautions mentioned in [text]. (Beatson.)
The condyles may each be broken loose by itself, or they may be both broken at the same time. [Fig. 291] illustrates what is known sometimes as a T-fracture, where the lower extremity is not only separated from the shaft but is broken into halves; such fractures imply great violence, and are particularly difficult to treat. Should the condyles be detached in such a way as to leave the lower end of the humerus in pointed wedge shape it may perforate or do much harm to the soft parts ([Fig. 290]). In these intercondyloid fractures the writer would advise dressing in the extended position, with a molded plaster-of-Paris anterior splint and a gentle degree of traction, the patient being confined to bed for a few days. In applying such a splint the surgeon should give extreme care to holding the fragments in proper position while the splint hardens, and in preserving the “[carrying function]” ([Fig. 291]). (See below.)
PLATE XXXIX