Atlas and epitome of traumatic fractures and dislocations . URES OF THE UPPER EXTREMITY. 151 a dislocation is too great force and the repetition of manip-ulations. In the majority of instances reduction shouldnot be attempted without anesthesia. This attempt shouldbe made in only those few dislocations which experiencehas taught us can be reduced by simple manipulation with-out great force, as in Kochers method for. shoulder dis-location. When the propermethods have been carefullytried without reduction underanesthesia, the probabilities arethat there is some obstacle;and in such an event furt
Atlas and epitome of traumatic fractures and dislocations . URES OF THE UPPER EXTREMITY. 151 a dislocation is too great force and the repetition of manip-ulations. In the majority of instances reduction shouldnot be attempted without anesthesia. This attempt shouldbe made in only those few dislocations which experiencehas taught us can be reduced by simple manipulation with-out great force, as in Kochers method for. shoulder dis-location. When the propermethods have been carefullytried without reduction underanesthesia, the probabilities arethat there is some obstacle;and in such an event furtherand more forcible attempts atreduction only increase the dan-ger of injury. The surgeonshould immediately expose thedislocation by an open incision,when in the majority of in-stances the obstacle can be re-moved and the bone easily re-placed.—Ed.] If reduction is neglected,there usually results a veryserious condition known as an old luxation.^ It is rare thata new joint with any degree ofmobility is formed ; as a rule,the shoulder-joint continues to. Fig. 53.—Simple dressing,by means of a gauze bandagestuffed with cotton, that maybe used after reduction of adislocation of the humerus. cause the patient pain, andmovement is reduced to a mini-mum. But even in these cases a surgical operation efPecting reduction after removal of ob-structions or resection of the head of the humerus may befollowed by considerable improvement. [As discussed onof the head of the humerus as a ruleserviceable arm than reduction of an page 147, resectionffives a much more old dislocation.—Ed.] 152 FRACTURES AND DISLOCATIONS. In rare cases habitual luxation results; the only success-ful method of treating it is a surgical operation consistingin resecting portions of the capsule for the purpose ofshortening it. Modifications and Complications of Preglenoid Dis=location.—If the head of the humerus escapes from theglenoid fossa in a direct line forward, it sometimes lies soclose to the fossa, be
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