The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . e great thickening of the capsule which at each side forms the lateralligament, are the most important factors in resisting displacement. In de-scribing dislocations, we speak of the lower bone as the one luxated. Thetibia may then be dislocated upon the femur, either backward, forward, inward,or outward. Backward Dislocation of the Tibia.—Causes.—Direct violence in theregion of the knee is the usual cause of this injury. Symptoms.—The head of the tibia is found, upon examination, to be dr
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . e great thickening of the capsule which at each side forms the lateralligament, are the most important factors in resisting displacement. In de-scribing dislocations, we speak of the lower bone as the one luxated. Thetibia may then be dislocated upon the femur, either backward, forward, inward,or outward. Backward Dislocation of the Tibia.—Causes.—Direct violence in theregion of the knee is the usual cause of this injury. Symptoms.—The head of the tibia is found, upon examination, to be drivenback toward the popliteal space, where it may be felt by the hand. In front,there is a corresponding vacuity, and a depression immediately below thepatella, on either side of the ligamentum patellae. The amount of shorteningis not uniform. Usually, the leg is extremely extended, and the line of thetibia slopes forward, forming an obtuse angle with that of the femur. Theligaments are more or less torn, according to the extent of the displacement. DISLOCATIONS OF THE KNEE-JOINT. 703 Fig. Backward dislocation of thetibia. and this has much to do with the prognosis. Anchylosis sometimes occurshere, as in other joints, when synovitis sets in after reduction. Usually,however, after replacement, a good recovery of all theoriginal functions may be predicted. When the luxa-tion is not reduced, there remains great imperfectionof the limb, but in many cases more mobility andstrength for walking exist than would naturally beanticipated. Treatment.—In a certain number of cases, where thedislocation is not quite complete, it may often be re-duced by manipulation alone without resorting toextension. For this purpose the patient may be laidupon his back, with a cushion under the calf of theleg, but not extending above the knee, thus leaving avacant space beneath the lower portion of the efforts are now to be made by the hands ofassistants to press the femur backw
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