. A practical treatise on fractures and dislocations . red atriple or quadruple rather than a double dislocation, as is impliedby the nomenclature adopted by Malgaigne. This we choose to regardas the only true dislocation of the astragalus, and as such we proposeto designate it by the simple term dislocation of the astragalus. The astragalus may be dislocated forwards, outwards, inwards, back-wards; or it may be dislocated obliquely in either of the diagonalsbetween these lines; it may be simply rotated upon its lateral axiswithout much, if any, lateral displacement; and, finally, it has beeno
. A practical treatise on fractures and dislocations . red atriple or quadruple rather than a double dislocation, as is impliedby the nomenclature adopted by Malgaigne. This we choose to regardas the only true dislocation of the astragalus, and as such we proposeto designate it by the simple term dislocation of the astragalus. The astragalus may be dislocated forwards, outwards, inwards, back-wards; or it may be dislocated obliquely in either of the diagonalsbetween these lines; it may be simply rotated upon its lateral axiswithout much, if any, lateral displacement; and, finally, it has beenoccasionally driven be-tween the tibia andfibula, tearing away theintermediate ligaments,and generally fracturingone or both, bones of theleg. Causes.—The causeswhich have been foundchiefly operative in theproduction of this dislo-cation are very much thesame as those which pro-duce, under other circum-stances, a dislocation of the lower end of the tibia. Thus, a fall froma height upon the bottom of the foot, accompanied with a violent ab- Fig. Dislocation of astragalus outwards. Anatomical relations. 698 TARSAL LUXATIONS. duction, adduction, flexion, or extension, may determine a dislocationof the astragalus inwards, outwards, backwards, or forwards. Some-times it is accomplished by a mere wrenching and twisting of the footin machinery, or in the wheel of a carriage, or by being caught be-tween two irregular bodies. It may be produced also by a direct —The great prominence occasioned by the displacementof the bone in either of these several directions, accompanied gene-rally with more or less lateral deviation of the foot, is alone sufficientto indicate the true nature of the accident. In some cases, also, thefoot is forcibly flexed or extended; the leg is shortened in conse-quence of the tibia having fallen down upon the calcaneum ; the super-incumbent skin and tendons are rendered tense; blood is effused, andswelling speedily occurs. In the backward di
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