A practical treatise on fractures and dislocations . ted, and rotated inwards; but the flexion is often less than indislocations upon the dorsum, while, on the other hand, it is sometimesmuch greater. Generally it is such that, when the patient is standing,the end of the great toe of the dislocated limb touches the ball of thegreat toe of the sound limb. Bigelow observes that the extremeflexion which is sometimes foundto exist, especially when the patientis in the recumbent position, isgenerally due to the arrest of thehead of the femur by the internalobturator and the subjacent untorncapsule.
A practical treatise on fractures and dislocations . ted, and rotated inwards; but the flexion is often less than indislocations upon the dorsum, while, on the other hand, it is sometimesmuch greater. Generally it is such that, when the patient is standing,the end of the great toe of the dislocated limb touches the ball of thegreat toe of the sound limb. Bigelow observes that the extremeflexion which is sometimes foundto exist, especially when the patientis in the recumbent position, isgenerally due to the arrest of thehead of the femur by the internalobturator and the subjacent untorncapsule. When the patient rises, theweight of the limb may force thehead up behind the tendon of theobturator; or if the limb is broughtdown with force, the tendon andcapsule may give way and the headmay ascend to any point upon theouter surface of the ilium, and in thlS Way an lSChiatlC may be COn- Dislocation upwards and backwards into the Verted intO an iliaC dislocation. great ischiatic notch. Below the tendon, when the patient is recumbent. (Bigelow.). 664 DISLOCATIONS OF THE THIGH. The head of the femur is sometimes distinctly felt in its new position,especially when the limb is moved upwards or downwards. The tro-chanter major is approximated toward the anterior superior spinousprocess of the ilium. Sir Astley Cooper remarks that this dislocation is the most difficultto detect, and Mr. Syme mentions a case in which, the nature of theaccident was overlooked by himself, and the thigh was not reduceduntil the thirteenth day ;x and subsequently Mr. Syme has called at-tention to what he considers as one of the most important diagnosticmarks—indeed, he says it is never absent, nor is it ever met with inany other injury of the hip-joint, whether dislocation, fracture, orbruise; this is an arched form of the lumbar part of the spine, whichcannot be straightened so long as the thigh is straight, or on a linewith the patients trunk. When the limb is raised or bent upwardsupon the pelvis
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Keywords: ., bookcentury1800, bookdecade1870, booksubjec, booksubjectfractures
