. Modern surgery, general and operative. oy extension and manipulation. Use asplint for one week. Pelvic Dislocations 765 Dislocations of the Ribs and Costal Cartilages.—The ribs may be dislocatedfrom the vertebrae. This accident is seldom uncomplicated, and cannot bedifferentiated from fracture without a skiagraph. The diagnosis is rarelymade, and the injury is treated as a fracture. The ribs may be dislocated fromtheir cartilages, one or more ribs being displaced. The end of the rib forms ananterior projection, there is a depression over the cartilage, and crepitus isabsent. Treatment is the
. Modern surgery, general and operative. oy extension and manipulation. Use asplint for one week. Pelvic Dislocations 765 Dislocations of the Ribs and Costal Cartilages.—The ribs may be dislocatedfrom the vertebrae. This accident is seldom uncomplicated, and cannot bedifferentiated from fracture without a skiagraph. The diagnosis is rarelymade, and the injury is treated as a fracture. The ribs may be dislocated fromtheir cartilages, one or more ribs being displaced. The end of the rib forms ananterior projection, there is a depression over the cartilage, and crepitus isabsent. Treatment is the same as that employed for fractured ribs. The cos-tal cartilages may be displaced from the sternum, forming an anterior projectionupon this bone. Reduction is brought about by placing the patient upon atable, with a sand-pillow between the scapulae, pushing back the shoulders andchest, and forcing the cartilage into place. The dressings are the same as thoseused for fractured sternum. The cartilages of the lower ribs (sixth, Fig. 469.—^Leviss splint for reducing dislocation of phalanges. eighth, ninth, and tenth) may be separated. The inferior cartilage goes for-ward and can be felt. Pick states that reduction is brought about by causingthe patient to hold the chest full of air while efforts are made to push the car-tilage into place. The injury is dressed as are fractured ribs (see page 624).Dislocation of the Sternum.—In dislocation of the body of the sternumthe manubrium is separated from the gladiolus. The injury is a rare one, isusually associated with fracture, and is most common in the young. It is duein most cases to violent direct force inflicted by a fall or heavy blow; it may bedue to indirect force and arose in a reported case of acute tetanus. The symp-toms and treatment are the same as those of fracture (see page 625). Dislocationof the ensiform process is one of the rarest of injuries. It is usually due to directforce, but Polaillon reports a cas
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