. A practical treatise on fractures and dislocations. injured limb; if he stands upright it shows moder-ate flexion and adduction, marked inversion, and more or less shorten-ing, the toes resting on those of the other foot. When he is placedupon his back the apparent adduction and flexion are increased, theknee resting just above the other patella or crossing the thigh at ahigher point. The contours of the outer and posterior regions of thehip are changed by loss of the normal depression behind the trochanter,elevation of the gluteal fold, and abnormal fulness due to the approxi- 1 Birkett: Me
. A practical treatise on fractures and dislocations. injured limb; if he stands upright it shows moder-ate flexion and adduction, marked inversion, and more or less shorten-ing, the toes resting on those of the other foot. When he is placedupon his back the apparent adduction and flexion are increased, theknee resting just above the other patella or crossing the thigh at ahigher point. The contours of the outer and posterior regions of thehip are changed by loss of the normal depression behind the trochanter,elevation of the gluteal fold, and abnormal fulness due to the approxi- 1 Birkett: Medico-Chirurgical Transactions, 1869, vol, lii. p. 133. 2Riedel : Beilage zum Centralbl. fiir Chir., 1885, p. 92. 3 Crile : Annals of Surgery, May, 1891. ^Lossen : Deutsche Chir., Lief. 65, p. 55. BACKWARD niSLOCATIONS OF THE HIP 807 mation of the insertions of the ghiteal museles. The troclianter risesto a variable distance above the line drawn from the anterior superiorspine of the ilium to the tuberosity of the ischium, and its distance ¥v;. 436. Dorsal dislocation of the hip. from the first-named prominence is increased. The head of the femurcan be obscurely felt through the gluteus maximus and recognized bvits movements when the limb is flexed or rotated. The empty socketcannot be felt from in front, because it is covered by the anterior por-tion of the capsule and the psoas and iliacus, but* the depressibihtyof the soft parts in Scarpas space is as great as, or greater than, thaton the opposite side, whereas in fracture of the neckof the fonuir thisdepressibihty is diminished. 808 DiSLOCATIoyS. The limb can be further adducted and flexed, but it cannot beabducted or rotated outward. The apparent shortening varies greatlyin degree in different cases, and the actual shortening cannot always bedetermined with accuracy because of the dif&culty in placing the limbssymmetrically. Concerning this shortening the most contradictorystatements have been made; some surgeons^ r
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
