A practical treatise on fractures and dislocations . erior spinousprocess of the ilium. When thehead rests directly below thisprocess, the dislocation is con-sidered anomalous or irregular,and this form will be consideredhereafter as the sub-spinousdislocation. In the accompanying drawingthe relation of the ilio-femoralligament to the head and neckof the femur is shown, when thehead ascends moderately uponthe pubes. The extreme dis-placement shown in the pre-ceding illustration from SirAstley Cooper is only possiblewhere that portion of the cap-sule beneath the obturator in-ternus is torn, and
A practical treatise on fractures and dislocations . erior spinousprocess of the ilium. When thehead rests directly below thisprocess, the dislocation is con-sidered anomalous or irregular,and this form will be consideredhereafter as the sub-spinousdislocation. In the accompanying drawingthe relation of the ilio-femoralligament to the head and neckof the femur is shown, when thehead ascends moderately uponthe pubes. The extreme dis-placement shown in the pre-ceding illustration from SirAstley Cooper is only possiblewhere that portion of the cap-sule beneath the obturator in-ternus is torn, and perhaps theobturator itself. According toBigelow, the ilio-femoral liga-ment and the psoas magnus andiliacus internus are then the onlyremaining causes of eversion. Symptoms.—The thigh isshortened, abducted, flexedslightly, rarely extended, androtated outwards. The trochanter major is lost, or nearly so, whilethe head of the bone may be generally felt like a round ball, lyingupon or in front of the body of the pubes to the outside of the femoral. Dislocation upon the pubes below the anterior in-ferior spine of the ilium. (From Bigelow.) 676 DISLOCATIONS OF THE THIGH, artery and vein. Larrey saw a patient in whom the femur was placednearly at a right angle with the body; and Physick once met with adislocation upon the pubes directly before the acetabulum, in whichthe limb was not at all shortened, but, on the contrary, a very Other surgeons have occasionally seen similar differential diagnosis between a fracture of the neck of thefemur and this dislocation may be thus briefly stated. In the fracture there is crepitus, mobility, slighteversion easily overcome, mode-rate or no shortening, no abduc-tion, the trochanter major rotateson a short radius, the head of thebone cannot be felt. In this dis-location there is no crepitus, thelimb is immobile, the eversion isextreme and not easily overcome,there is generally more shortening,the thigh is abduc
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Keywords: ., bookcentury1800, bookdecade1870, booksubjec, booksubjectfractures
