A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . shouldput his knee against the spine of the patient and place his hands on thetwo shoulders. A backward dislocation will probably be reduced bya similar manipulation of the shoulder with or without the use of thefingers to lift the sternal end forward. The upward luxation may bereduced by drawing the shoulder outward and making direct pressuredownward and outward upon the sternal end of the dislocated reduction in all f
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . shouldput his knee against the spine of the patient and place his hands on thetwo shoulders. A backward dislocation will probably be reduced bya similar manipulation of the shoulder with or without the use of thefingers to lift the sternal end forward. The upward luxation may bereduced by drawing the shoulder outward and making direct pressuredownward and outward upon the sternal end of the dislocated reduction in all forms of dislocation here is usually easy, but it isdifficult to prevent recurrence of the displacement. The supine posi-tion in bed for several weeks, as in fracture of the clavicle, wouldperhaps be of advantage on this account after the dislocation is bandage with a proper pad should be worn for several weeks if thepatient remains out of bed as he usually does. Nailing the bone tothe sternum with an aseptic nail will probably be efficient. Wiringmay also be performed or the head of the bone may be excised, if itgives trouble from pressure. Fig. Dislocation upward of the sternal end of the clavicle. (R. W. Smith.) Dislocations of the Scapula. Pathology.—These injuries are often called dislocations of theacromial end of the clavicle ; but, in accordance with the rule that thedistal bone is the one said to be displaced, they are better called scapulardislocations. They are caused by direct violence or muscular scapula may be displaced below, above or behind the acromialend of the clavicle. In complete dislocations the coraco-clavicularligament is torn to a greater or less extent, as well as the capsular liga-ment of the joint. Symptoms.—The subclavicular dislocation is marked by the 532 INJURIES OF JOINTS, CARTILAGES AND LIGAMENTS. prominence of the clavicle upon the top of the acromion and the par-tial rotation of the lower angle of the scapula tow
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