. Modern surgery, general and operative. nerves). In dislocationbackward there is apparent shortening of the leg, eversion of the foot exists, 766 Diseases and Injuries of the Bones and Joints and the ilium moves posteriorly and upward. In dislocation forward the ante-rior superior iliac spine projects and the pelvis is broadened. Sacro-iliac dis-location is reduced by holding the pelvis firm and making extension by meansof a pulley. The patient stays in bed for four weeks and wears a pelvic beltas in fracture. Dislocation of the coccyx is considered on page 629. Dislocation of the Femur (Hip-
. Modern surgery, general and operative. nerves). In dislocationbackward there is apparent shortening of the leg, eversion of the foot exists, 766 Diseases and Injuries of the Bones and Joints and the ilium moves posteriorly and upward. In dislocation forward the ante-rior superior iliac spine projects and the pelvis is broadened. Sacro-iliac dis-location is reduced by holding the pelvis firm and making extension by meansof a pulley. The patient stays in bed for four weeks and wears a pelvic beltas in fracture. Dislocation of the coccyx is considered on page 629. Dislocation of the Femur (Hip-joint).—Dislocation of this joint is not oftenencountered, as the hip-joint is very strong. In 23,000 surgical admissions tothe Episcopal Hospital of Philadelphia, 6000 of which were surgical injuriesthere were 10 dislocations of the hip (Steinke, in Annals of Surgery, 1914, Ix). It is far more common in males than in females and is most apt to occur in ayoung adult. It is very rare in those beyond middle life but occasionally occurs. Fig. 471.—Thyroid dislocation of the femur eight weeks after the accident. Reduced by-open section (Rugh). in the early sixties. In forcible extension the head of the femur presses againstthe capsule of the joint, but the capsule here is very thick, and certain muscles,the rectus, psoas, and iliacus, are pulled tight and serve to strengthen it. Thehead of the bone cannot go directly upward because of the acetabulum (Ed-mund Owen). The weak point of the acetabular rim is below; the weak partof the capsule is also below; hence forced abduction is apt to push the head of thebone through the lower part of the capsule, a dislocation occurring primarilyinto the thyroid foramen. The signs of the dislocation depend upon the untornportion of the capsule. The anterior portion of the capsule, including the Y-hga-ment, usually escapes laceration. Vessels are rarely injured. Muscles areoften torn. In some cases the sciatic nerve is lacerated, bruised, or c
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