Annual and analytical cyclopaedia of practical medicine . ns of Dislocations of theHip.—Compound dislocations are veryrare. Injury to the femoral vessels may oc-cur in forward and inward dislocations. Fracture of the neck of the femur isusually caused by overzealous attemptsat reduction. Ankylosis with the limbin a favorable position is the best thatcan be hoped for, except possibly in the 24 DISLOCATIONS. KXEE. TREATMENT. 3^oinig, when excision of the head of thebone may give some useful motion. Treatment of Old Unreduced Disloca-tions.—Of the operative procedures, re-duction by arthrotomy gi
Annual and analytical cyclopaedia of practical medicine . ns of Dislocations of theHip.—Compound dislocations are veryrare. Injury to the femoral vessels may oc-cur in forward and inward dislocations. Fracture of the neck of the femur isusually caused by overzealous attemptsat reduction. Ankylosis with the limbin a favorable position is the best thatcan be hoped for, except possibly in the 24 DISLOCATIONS. KXEE. TREATMENT. 3^oinig, when excision of the head of thebone may give some useful motion. Treatment of Old Unreduced Disloca-tions.—Of the operative procedures, re-duction by arthrotomy gives a long listof deaths as opposed to two successes (byParkes), while excision of the head, or ofthe head, neck, and trochanter, and sub-trochanteric osteotomy have frequentlydecreased the disability. In many cases,however, the patients do reasonably wellwithout operation, and these personsneed expect no cure from the knife. Dislocations of the Knee.—Theseoccur rarely and, in order of frequency,forward, backward, outward, inward, and 5 6 2<Cbi. Fig. 15.—Diagram of the various dislocationsof the patella. (Stimsoii.) by rotation. The dislocation is fre-quently compound, and the prognosisrendered much more grave by a compli-cating injury to either of the poplitealnerves or to the popliteal vessels. Evenif, after reduction, pulsation reappear inthe arteries of the foot, gangrene maysupervene from thrombosis caused bylaceration of the inner coats of the dislocation may be complete,or, more commonly, incomplete. Whencomplete, the tibia may Ijc displacedsome distance upward over the front ofthe condyles. If the dislocation is com-pound, the wound is posterior and trans-verse. The cause is direct violence or hyperextension of the knee. Eeductionis easily made l)y traction and pressure. Backward dislocations may be com-plete or incomplete. The leg is usuallyeither extended or hyperextended, andma} be deviated to one side. The patellamay be dislocated outward.
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