. The principles of surgery . r freedom and extent of motion. In alg * macerated pelvis, evi- dently obtained from apatient who had livedlong after the occur-rence of dislocation, Ihave seen two acetabulain close apposition ; theone original, the otherof adventitious forma-tion ; and both appa-rently of almost equallyefficient capabilities. Af-ter a time, however—various in different cases,yet never brief—theoriginal articulating sur-face does change materially. Its cavity is filled up, and its investingcartilage disappears ; its projections are rounded off by absorption; itbecomes incorporate
. The principles of surgery . r freedom and extent of motion. In alg * macerated pelvis, evi- dently obtained from apatient who had livedlong after the occur-rence of dislocation, Ihave seen two acetabulain close apposition ; theone original, the otherof adventitious forma-tion ; and both appa-rently of almost equallyefficient capabilities. Af-ter a time, however—various in different cases,yet never brief—theoriginal articulating sur-face does change materially. Its cavity is filled up, and its investingcartilage disappears ; its projections are rounded off by absorption; itbecomes incorporated with the surrounding soft parts ; and these changestake place all the more speedily and effectually, if the new articulatingsurface be in its immediate vicinity, and encroach on its seems good reason to believe, also, that the less the synovial cap-sule has been injured, and the more freely it continues its secretivepower, the less speedy and complete are the obliterative changes in theoriginal Fig. 236. Old dislocation of the hip. A new acetabulum formed ; while the originalis but little changed.—Sir A. TREATMENT OF DISLOCATION. 679 Treatment.—The paramount indication is Reduction, and cannot beattempted too soon. It consists of extension, to move the bone from itsabnormal position, and to bring it on a plane with the articulating sur-face it has left; counter-extension, to steady the latter part, and toadmit of extension being satisfactorily effected ; and coaptation, to re-place the surfaces in apposition. If the patient be seen immediatelyafter infliction of the injury; still faint; with all his frame prostrateand relaxed; and incapable, by any effort, of throwing any part of hismuscular system into strong resisting action—reduction may be expectedto prove comparatively easy. The surgeon is able to cope with theaccident, single-handed. In the case of the shoulder, for example, hetakes hold of the elbow with his right hand, and
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