. The principles and practice of surgery. eduction is effected by the same manipulation which has alreadybeen described for dislocation upon the dorsum. If, during the manip-ulation, the thigh is very much flexed upon the abdomen, there is greatdanger that the head of the femur will be carried around the lowermargin of the acetabulum into the foramen thyroideum. This hashappened to me twice, but with no serious results, the head of the bonebeing easily carried back by reversing the manipulation. This dislocation may also be reduced by extension applied in thesame manner as for dislocation upon
. The principles and practice of surgery. eduction is effected by the same manipulation which has alreadybeen described for dislocation upon the dorsum. If, during the manip-ulation, the thigh is very much flexed upon the abdomen, there is greatdanger that the head of the femur will be carried around the lowermargin of the acetabulum into the foramen thyroideum. This hashappened to me twice, but with no serious results, the head of the bonebeing easily carried back by reversing the manipulation. This dislocation may also be reduced by extension applied in thesame manner as for dislocation upon the dorsum, only that the thighmust be more flexed while the extension is being made. Dislocation upon the Pubes, less frequent than either of the otherforms of hip-joint dislocation, is generally caused by a fall upon the footwhen the pelvis and belly are thrown forwards. The leg is generallyshortened, abducted slightly, and rotated outwards, and the head orneck of the femur may be felt over the horizontal ramus of the pubes. Fig. Reduction of Dislocation upon the Pubes, by Extension. If the head of the femur has fairly traversed the pubes, so that itrests over the pelvic cavity, while the neck rests upon the pubes, exten- DISLOCATIONS OF THE FEMUR. 335 Fig. 144. sion must precede manipulation, or if manipulation is at once em-ployed, the first step will be to rotate the thigh outwards and abduct itvery forcibly so as to throw the head upon the pubes; after whichforced flexion, adduction, and finally rotation inwards, will carry thehead into the acetabulum. In case the head rests upon the pubes, thefirst step of the process just described may be omitted. Extensionemployed alone has sometimes succeeded. Dislocation into the Foramen Thyroideum.—Caused generallyby a forced abduction of the thigh, or by a weight received upon theback of the pelvis while the body is bent and thethigh abducted. The limb is found abducted, somewhat flexedupon the body, and rotated outwards.
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectg, booksubjectsurgery
