. Minor surgery and bandaging; including the treatment of fractures and dislocations, the ligation of arteries, amputations, excisions and resections, intestinal anastomosis, operations upon nerves and tendons, tracheotomy, intubation of the larynx, er.) they are described as iliac or dorsal, the bone resting uponthe dorsum of the ilium (Fig. 324); or the dislocation maybe backward, the head of the bone resting upon the ischi-atic notch; these are known as ischiatic dislocations, or dis-locations of the femur, dorsal below the tendon (of theobturator internus), according to Bigelow (Fig.
. Minor surgery and bandaging; including the treatment of fractures and dislocations, the ligation of arteries, amputations, excisions and resections, intestinal anastomosis, operations upon nerves and tendons, tracheotomy, intubation of the larynx, er.) they are described as iliac or dorsal, the bone resting uponthe dorsum of the ilium (Fig. 324); or the dislocation maybe backward, the head of the bone resting upon the ischi-atic notch; these are known as ischiatic dislocations, or dis-locations of the femur, dorsal below the tendon (of theobturator internus), according to Bigelow (Fig. 325). DISLOCATIONS OF THE HIP. 431 The reduction of the posterior dislocations of the femurcan generally be effected by manipulation. The patientbeing anaesthetized and placed upon his back, the surgeongrasps the leg at the ankle and knee, flexes the leg uponthe thigh, and the thigh upon the pelvis in the position ofadduction; he then abducts the limb and rotates it out-ward, bringing it in a broad sweep across the abdomen,and by bringing it down to its natural position the headof the bone will slip into the acetabulum (Fig. 326). Kocher, in posterior dislocations, recommends the fol-lowing manipulations: 1. The surgeon grasps the ankle Fig. Reduction of backward dislocation of the femur. (Bigelow.) of the injured limb with one hand and the front of theknee with the other, and rotates the thigh inward, to relaxthe capsule and lift the head of the bone from the posteriorsurface of the pelvis. 2. The thigh is next flexed to 90degrees, preserving the existing adduction and inwardrotation. 3. Traction is then made in the line of thefemur, to make the capsule tense. 4. External rotationis then practised, which makes the posterior part of thecapsule and Y-ligament tense, and returns the head of thebone to the acetabulum. Allis, in the reduction of dorsal dislocations, recom-mends that, while the patient is supine, the surgeon kneel 432 DISLOCATIONS. beside him, and in the case
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1902
