ONE
Dilemma
“It has been the experience of all who treat tuberculous joints
that bony ankyloses [joint fusion] is the most satisfactory result
which can be obtained. No other result assures equal permanency
of cure and freedom from late recurrences. The truth is that our
means of treating tuberculosis are limited and only feebly
effective. In the last analysis, it is the patient himself who
masters the infection. We have no specific drug, serum, or
therapeutic agent, the use of which will quickly kill the
organisms. [Only two things] are of any material value: rest and
sunshine.”
—R. I. Harris, Toronto, Ontario, 1935^1“Dr. Neer became disenchanted with the end results of patients
with fractures of the proximal humerus treated with resection of
the humeral head. He mentioned this to Dr. Darrach who said,
‘Smiley, why don’t you do something about it?’”
—Charles Rockwood, MDMy heart sinks when I hear that Miranda has dislocated her shoulder
again. I first met her a year ago, when she estimated that she had
dislocated both shoulders dozens of times each. As a seizure patient,
Miranda is susceptible to a particularly diabolical type of dislocation
where the humeral head is forced backward (posterior) and out of joint,
instead of the usual anterior dislocation, in which the humeral head is