. The principles and practice of modern surgery. ibula being also broken; the foot ap-pears shortened and immovable, and the heel cannotbe brought to the ground, [see Figs. 90, 91.] (4.) Adislocation backwards has been described; but it mustbe excessively rare, as Sir A. Cooper never saw is a case of it described by Mr. Colles, which,however, was probably one of transverse fracture of thetibia and fibula just above the joint, with displacementbackwards. The fracture of the fibula about threeinches above the outer malleolus, which accompanies thedislocation inwards, is commonly called
. The principles and practice of modern surgery. ibula being also broken; the foot ap-pears shortened and immovable, and the heel cannotbe brought to the ground, [see Figs. 90, 91.] (4.) Adislocation backwards has been described; but it mustbe excessively rare, as Sir A. Cooper never saw is a case of it described by Mr. Colles, which,however, was probably one of transverse fracture of thetibia and fibula just above the joint, with displacementbackwards. The fracture of the fibula about threeinches above the outer malleolus, which accompanies thedislocation inwards, is commonly called Potts —The patient must be laid on the affect-ed side, and the knee must be bent, (to relax the gas-trocnemius,) and be firmly held by an assistant. Thesurgeon must then grasp the instep with one hand,and the heel with the other, and make extension,(aided by pressure on the head of the tibia,) till he hasrestored the natural shape and mobility of the the limb must be put up with a splint on each Fig. 90. Fig. 24^ 282 DISLOCATIONS OF THE FOOT. side, in the same manner as a fracture of the lower part of the leg, takingcare to keep the great toe in its proper line with the patella. Compound Dislocation of the ankle-joint is by far the most frequentexample of that kind of injury. If the wound in the integuments doesnot heal by the first intention, the joint inflames; suppuration occurs inabout five days;—much of the cartilage is destroyed by ulceration; atlast the wound is filled with granulations, and the patient recovers atolerably good use of the foot in from two to twelve months. The firstthing to be done is, to wash away all dirt with warm water; to removeany shattered pieces of bone gently with the finger, and then to reducethe bone to its place; slightly enlarging the wound in the skin if neces-sary, in order to effect this without violence. If it is very difficult toreturn the end of the tibia, or if it is fractured obliquely, or much
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