ARTHROTOMY OR REDUCTION.
When it is decided to be expedient or imperative to operate on an arm which resists reduction by ordinary methods, the question arises as to whether we will expose the articular head by a free incision, and remove it through the anatomic neck, or rather preserve and restore it by an arthrotomy. On this point surgeons are not in complete accord.Resection is much the simpler procedure. The capsule is preserved and the attachments of the deep pronators are maintained, but the articulation is destroyed; an important anatomic structure is gone.Arthrotomy and forcible reduction of the head usually entails an extensive mutilation and free hemorrhage. Sometimes all the muscular attachments to the outer head must be divided, and if the circumflex nerve has suffered damage, or if there be an osseous lesion, after the head is replaced it can not be retained. "Bloody reduction," says Knapp,
MANLEY TH. SHOULDER-HUMERO-SCAPULA ARTICULATION.SOME OF THE COMPLICATIONS AND SEQUELAE ATTENDING OR FOLLOWING REDUCIBLE OR IRREDUCIBLE DISLOCATIONS, WITH A BRIEF REVIEW OF THE VARIOUS MODERN OPERATIVE MEASURES NOW EMPLOYED FOR THEIR TREATMENT.. JAMA. 1900;XXXIV(15):917–920. doi:10.1001/jama.1900.24610150023001l