Annual and analytical cyclopaedia of practical medicine . C Ilio-pectineal. Forward > Suprapubic < Pubic,and Upward j ( Intrapelvic. Dislocations directly upward (supracotyloid or subspinous).Dishx-ations downward on the tuberosity of the ischium. Barl-v:ard Dislocations. — The dorsalform is by far the most common of thedislocations of the hip. The thigh isadducted, rotated inward, and more orless flexed; so that the knee rests uponthe front of the opposite thigh when thepatient is recumbent, and there is appar-ent shortening (Fig. 13). The upper andouter part of the thigh is broadened,
Annual and analytical cyclopaedia of practical medicine . C Ilio-pectineal. Forward > Suprapubic < Pubic,and Upward j ( Intrapelvic. Dislocations directly upward (supracotyloid or subspinous).Dishx-ations downward on the tuberosity of the ischium. Barl-v:ard Dislocations. — The dorsalform is by far the most common of thedislocations of the hip. The thigh isadducted, rotated inward, and more orless flexed; so that the knee rests uponthe front of the opposite thigh when thepatient is recumbent, and there is appar-ent shortening (Fig. 13). The upper andouter part of the thigh is broadened, and the trochanter is above Xelatous line (aline drawn from the antero-superior spineof the ilium to the tuberosity of theischium). The head of the femur maybe obscurely felt in the buttock. The actual shortening cannot easily bedetermined on account of the difllicultyof placing the two liml)S in .symmetricalpositions. Voluntary movement and fric-tion are lost; passive flexion and adduc-tion alone are possible. The characteristic position and limita-. Fiff. -Dorsal dislocation of femur.(Cooper.) tion of motion readih distinguishes thedislocation from a fracture of the neckof the femur. Etioloc]]).—The dislocation is usuallyproduced by violence transmitted alongthe shaft of the femur while the thigh isflexed, adducted, and rotated inward; orthe head of the bone may be thrown outof place by exaggerated adduction, in-ward rotation, and slight flexion; or,again, the dislocation may result second- 32 DISLOCATIONS. HIP. TREATMENT. aril}- from an obturator dislocation bythe same three motions. Patlwhgy.—The head of the bone usu-ally tears through the capsule low downbehind, passes below and then upwardbehind the obturator, and rests finallyon that muscle close behind the acetabu-lum, or, more rarely, it leaves its sockethigher up, pushes the obturator ahead ofit outward or upward, and lies on theedge of the acetabuhmi itself. The cap-sule is irregularly torn behind, the lig
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