Interstate medical journal . down about 1 Vz inches with every step. these two postures are accomplished the muscles are usually re-laxed enough to allow you to attempt replacement. This is doneby flexing the thigh with the leg extended, until the latter touchesthe anesthetists cone, then, with flexed knee, rotating and abductingthe thigh until it reaches a position in a plane posterior to the but-tocks. While this is done the thumb is pressing under the tro-chanter. If the head of the femur and acetabulum are fairly wellformed, if the displacement upward is not too great, the replace- 734 INT
Interstate medical journal . down about 1 Vz inches with every step. these two postures are accomplished the muscles are usually re-laxed enough to allow you to attempt replacement. This is doneby flexing the thigh with the leg extended, until the latter touchesthe anesthetists cone, then, with flexed knee, rotating and abductingthe thigh until it reaches a position in a plane posterior to the but-tocks. While this is done the thumb is pressing under the tro-chanter. If the head of the femur and acetabulum are fairly wellformed, if the displacement upward is not too great, the replace- 734 INTERSTATE MEDICAL JOURNAL ment now usually takes place without much difficulty and givesevidence of its new corrected position, first, by a loud click, usuallyfelt and heard; second, by the presence of the head in the groin;third, by the resistance offered to an attempt to straighten the legon the thigh. This is the method par excellence and in most of thecases of desirable age, success is assured without excessive bruising mm. Fig. 10.—Congenital dislocation of bothhips untreated in a young woman 22years old. A diagnosis was not madeuntil she was 19 years old. Noticethe prominence of the trochantersand the space between the upperthighs. This girl is of a very strongphysical type, but is disabled by thecrippled hips. She can walk only afew blocks at a time. Fig. 11.—Double congenital, untreated,unreduced dislocation of the hips ina woman 44 years old. Osteo-arthritis, favored by the trauma, de-veloped, the deformed heads andnecks have flattened out and wornaway. This case was diagnosed at32 years of age. of the parts or fracture of the thigh which was so common in theearly cases. Even in the older cases this method, in the hands ofthose experienced, will prove successful if the condition of theanatomical parts and the degree of displacement will allow. Instrumental reduction is practiced in the East and consists ofreducing the hip by means of blades and screws fixed to a spec
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