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 . tated upon itsaxis so as to stand upon one edge, orit may be turned entirely over so thatthe cartilaginous surface is directly underthe skin. The outward displacement ismore common than the inward, becauseof the oblique manner in which themuscular and tendinous fibers of theextensor muscle are attached to it andbecause of the size and shape of the ar-ticular surface of the external other dislocations of the patella a
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 . tated upon itsaxis so as to stand upon one edge, orit may be turned entirely over so thatthe cartilaginous surface is directly underthe skin. The outward displacement ismore common than the inward, becauseof the oblique manner in which themuscular and tendinous fibers of theextensor muscle are attached to it andbecause of the size and shape of the ar-ticular surface of the external other dislocations of the patella arerare. Muscular contraction as well asdirect violence may cause the luxation. The symptoms are change in shape olthe joint and absence of mobility. Inreducing a dislocation of the patella thequadriceps extensor muscle should berelaxed as far as possible by flexing thehip and extending the knee. Directpressure may then be sufficient to replacethe luxated sesamoid bone. RapidlyAuthors case of ^reduced dislocation of succeedmg partial flexions and complete extensions of the leg, with manipulationof the bone and pressure in a direction opposite to that of the dis-. DISLOCATIONS AT THE T1BI0-FIBULAR JOINT. 549 location will sometimes be effective when other means fail. Incisionso as to give direct access to the bone is proper when manipulation hasbeen unavailing. Dislocations of the Semilunar Cartilages. Dislocation of the intra-articular cartilages of the knee may occuras the result of excessive flexion or a sudden wrench of the displacement is generally backwards, but it may be inner cartilage is more apt to be displaced than the outer the displacement is towards the periphery the cartilage mayproject as a ridge at the upper border of the tibia. A relaxed kneejoint or previously injured crucial ligaments may be predisposingcauses. The cartilage when pressed out of place may become crum-pled or bent upon itself and wedged between the femur and tibia
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