Carlos C. Booth
1919 Journal of the American Medical Association  
upper surface (Figs. 1 and 2 B). The part of the arm board in contact with the semicircle is also beveled at the expense of its under surface. The stationary semicircular piece and the movable arm board are held together at this beveled joint by a small board beneath the arm board, which is attached to the arm board and to a screw in the center of the fixed semicircular piece (Fig. 2 E) . The arm board is supported by a board running from the upright attached to the operating table to the outer
more » ... end of the arm board. In order to allow rotation of this piece, a ball and socket joint is provided at its junction with the upright attached to the operating table (Figs. 1 and 2 C). To allow a change of position of the patient's arm in the vertical plane, a superimposed board, the same size as the arm board and supported by four legs, is employed. These supports run through slots in the arm board proper; and by means of pegs inserted in holes in the supports, the outer or inner end or both ends of the superimposed board may be raised. This superimposed board may be removed entirely, but we have found it to have definite advantages in obtaining stability of the patient's arm. The degree of adjustability of the board in the horizontal plane, increasing the abduction or adduction of the arm, is shown in the accompanying illustrations. In the illustrations the foreshortening lessens the apparent degree of rotation, which may be seen by noting the change in the patient's axillary fold. boy, aged 9 years, is healthy and normal in all respects except for the left upper extremity, which at first sight resembles very closely an intra-uterine amputation Fig. 1.-Congenital malformation of forearm, lateral view. Fig. 2.-Congenital malformation of forearm, anteroposterior view. through the upper third of the forearm. The humerus is normal in size and function. There is normal range of motion at the elbow. The radius and ulna are palpable, and at their distal end is a small piece of bone, to which is attached a flexor and an extensor tendon. This small bone, evidently a rudimentary metacarpal bone, can be very easily flexed and extended. The stump is well shaped and padded. The roengenograms show that the condition is not an intrauterine amputation, since both the radius and the ulna are practically perfectly formed, being only half or one third the normal length. There is complete absence of carpal and metacarpal bones, with the exception of the single rudimentary metacarpal bone, and absence of phalanges. When the boy becomes older, an artificial arm will be ordered.
doi:10.1001/jama.1919.26110130003010d fatcat:k5sbix47z5alhd2u6i3bzzuznm