. A treatise on dislocations and fractures of the joints. rom the appearance of the parts, the dislocationmust have existed many years; the adhesions were too strong to haveadmitted of any reduction, and if reduced, the bone could not haveremained in its original socket. * I have heard it a matter of discussion between equally competent surgeonsrespecting a case of dislocation, whether the head of the bone was placed upon thedorsum of the ilium or in the ischiatic notch, the dispute arising as to the extent ofshortening of the limb, which, in my opinion, docs not form a very perfect diagnostic
. A treatise on dislocations and fractures of the joints. rom the appearance of the parts, the dislocationmust have existed many years; the adhesions were too strong to haveadmitted of any reduction, and if reduced, the bone could not haveremained in its original socket. * I have heard it a matter of discussion between equally competent surgeonsrespecting a case of dislocation, whether the head of the bone was placed upon thedorsum of the ilium or in the ischiatic notch, the dispute arising as to the extent ofshortening of the limb, which, in my opinion, docs not form a very perfect diagnosticmark; tor the limb becomes invariably shorter as the space of time increases sincethe accident has occurred, so that it may vary from half an inch at first to a subse-quent shortening of three inches. The best sign of this accident, I believe is thegreater displacement of the head of the thigh-bone backwards, and the consequentobliquity of the shaft, so as to direct the knee across the middle of the opposite thighinstead of just above the patella.— INTO THE ISCHIATIC NOTCH. 61 Cause.—This species of dislocation is produced by the applicationof force, when the body is bent forward upon the thigh, or when thethigh is bent at right angles with the abdomen; in which positions, ifthe knee be pressed inward, the head of the bone is thrown behind theacetabulum. The reduction of the dislocation into the ischiatic notch is, in gen-eral, extremely difficult, but is to be effected in the same manner asdirected for the reduction of a dislocation on the dorsum ilii, except-ing that the direction of the extending force is to cross the middle ofthe sound thigh instead of one third above the knee, and moreover,the patient is placed on his side, instead of on his back ; but themode of fixing the pelvis and the apparatus for extension, is precisely
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Keywords: ., bookcentury1800, bookdecade1840, booksubjectfractur, bookyear1844
