A system of surgery . Fig. 411.—Flexion, Abduction and Rotation inwards in Pubic or Obturator Dislocations. Rotate inwards and extend (Fig. 411). By this means theof the bone retraces its steps into the aceta-bulum. In some cases of this manipula-tion, too forcible flexion of the thigh maypress the displaced head backwards to-wards the sciatic region. Abduction androtation outwards may then succeed, whenthe previous manipulation has failed. So,too, flexion of the thigh and lifting thehead of the femur outwards and upwardsinto the acetabulum, combinedwith rotation inwards and out-wards, have pr
A system of surgery . Fig. 411.—Flexion, Abduction and Rotation inwards in Pubic or Obturator Dislocations. Rotate inwards and extend (Fig. 411). By this means theof the bone retraces its steps into the aceta-bulum. In some cases of this manipula-tion, too forcible flexion of the thigh maypress the displaced head backwards to-wards the sciatic region. Abduction androtation outwards may then succeed, whenthe previous manipulation has failed. So,too, flexion of the thigh and lifting thehead of the femur outwards and upwardsinto the acetabulum, combinedwith rotation inwards and out-wards, have proved the surgeon is adduct-ing the flexed limb, a powerfulassistant may pass a jack-towel round the thigh, and thepelvis being firmlyfixed, he, passinghis shouldersthrough the towel,heaves upwardsand outwards,while the surgeonadducts the limband rotates it in-wards. This dislo-cation has alsobeen reduced by head. Fig. 412.—Position of the Head of the Femur in Pubic Dislocations. DISLOCATIONS OF THE HIP. 1005 If violent extension and placing a heavy sand-bag, or the well-padded bed-post, between thethighs and adducting the limb upon these as a fulcrum. 4. Dislocation forwards and inwards on to the pubes,dislocation under the crural arch (Fig. 412). Condition ofsoft parts.—The pubic dislocation may be looked upon as afurther degree of obturator displacement,rotation outwards occurs, the head of thefemur will mount upwards and forwardsbeneath Pouparts ligament. The softparts are torn and lacerated to much thesame extent as in the obturator disloca-tion. The capsule is torn inferiorly, but,according to Gunn, anteriorly also, to amarked extent. The head of the bonelies usually nearer the ilium than thepubes, to the outer side of the femoralvessels ; the crural nerves are, therefore,often stretched considerably. The headof the femur may pass under Poupartsligament for a considerable distance up-
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