A practical treatise on fractures and dislocations . relax this ligament, and then reduction may be effectedby extension directly forward, the thigh being at a right angle with the body,or by rotation. In some cases, where there is probably only a button-hole slitin the capsule, free circumduction may be required in order that the capsulemay be torn more freely. His method of reducing the dislocation upon thedorsum ilii, is to flex the thigh upon the abdomen, abduct and then rotate out-ward ; or, to flex, then adduct and rotate a little inward, to disengage the headof the bone from behind the
A practical treatise on fractures and dislocations . relax this ligament, and then reduction may be effectedby extension directly forward, the thigh being at a right angle with the body,or by rotation. In some cases, where there is probably only a button-hole slitin the capsule, free circumduction may be required in order that the capsulemay be torn more freely. His method of reducing the dislocation upon thedorsum ilii, is to flex the thigh upon the abdomen, abduct and then rotate out-ward ; or, to flex, then adduct and rotate a little inward, to disengage the headof the bone from behind the socket, then abduct and pull directly necessary, circumduction is practised to lacerate the capsule more com-pletely. Prof. Gunn, of Chicago, says : For the easy reduction of a dislocated hip orshoulder, the limb should be placed in, as nearly as possible, the same positionas that which most frequently characterizes it at the instant of escape. Andspeaking especially of dislocations of the femur upon the dorsum ilii, he adds: Fig. Relaxation of the ilio-femoral ligament by flexion. (Bigelow.) If we now flex, adduct, and inwardly rotate to a still greater degree, we shallloosen the anterior and inferior tense untorn portion which is holding the headhooked outside the acetabular ridge, and then by a moderate amount of forcewe may draw the head into the socket. This is most conveniently accomplishedby putting the patient on the floor on his back; an assistant fixes the pelvis ;the surgeon grasps the limb, flexes and adducts it till it crosses the limb of theopposite side at a point as high as the union of the upper with the lower two-thirds of the femur; now rotating the limb inwardly, he will be able to lift thehead into place by a moderate effort. (b) Reduction by extension dates from a period equally early withreduction by manipulation. Hippocrates recommended, when other andgentler means had failed, to make extension and counter-extension; theextending bands
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Keywords: ., bookcentury1800, bookdecade1890, booksubjec, booksubjectfractures
