File:The diseases of children - medical and surgical (1900) (14783902602).jpg

Identifier: diseasesofchildr00ashb (find matches)
Title: The diseases of children : medical and surgical
Year: 1900 (1900s)
Authors: Ashby, Henry, 1845-1908 Wright, G. A. (George Arthur), b. 1851 Northrup, William Perry
Subjects: Pediatrics
Publisher: New York : Longmans, Green
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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quent accident, but in our experience it isnot nearly so common as the diastasis of the humerus. We have once met with diastasis of the upperfemoral epiphysis (vide HipDisease in Childhood, by one ofthe present writers) and ^ whichpossibly (Plate XIV.) may havebeen a case of diastasis and frac-ture combined. Poland has col-lected a number of instances.Occasionally diastases are metwith at the upper end of thetibia.- Tubby -^ has collectedcases of separation of theclavicular epiphysis. The dia-gnosis depends upon the age ofthe patient, the fact that theprojecting edge of the bone issharp and unlike the natui-alinner end of the clavicle, as itwould be in the case of a dislo-cation, and also in that alamella of bone can be felt be-tween the sternal notch and theend of the shaft. It must beremembered that the epiphysisis only an extremely thinplate. We have lately met withan instance of this injury. According to Tubby, separa-tion of the coracoid epiphysis isof extreme rarity, and no case
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■ Separation of the Upper Epiphysis of theRight Humerus. of separation of the acromial epiphysis appears to be authentic. Diastasis of the upper end of the humerus is not rarely met with. Itresults from injuries such as blows or falls upon the arm, which, in the ^ See also Stimson on Fractures, and Hutchinson, Arch, of Surgery, April 1892, andTubby, A/mals of Surgery, 1894, vol. xix. - Separation of the upper epiphysis of the tibia has been caused by the bad practice ofapplying extension for hip disease below the knee instead of above it. • Guys Reports, 1889. Note.—For an account of separation of epiphyses due to congenital syphilis (syphilitictelostitis) vide chapters on Congenital Syphilis and on Bone Diseases. Similarmultiple separations may be the result of so-called scurvy rickets. Separation of tJic Epiphyses 805 adult, would probably cause either fracture of the shaft or dislocation of theshoulder. It appears to be not uncommonly the result of injury at birth.The appeara

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