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 . ed in such a position that the arm is ele-vated and lies near the side of the head, andwhen because of fracture of the coracoid proc-ess or acromion the head of the bone is situ-ated above the coracoid process. The demonstrable position of the head easilydetermines the variety of forward dislocationpresent. The symptoms are those mentionedpreviously as pertaining to dislocations of thehumerus. Downward Dislocation. — The truedow
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 . ed in such a position that the arm is ele-vated and lies near the side of the head, andwhen because of fracture of the coracoid proc-ess or acromion the head of the bone is situ-ated above the coracoid process. The demonstrable position of the head easilydetermines the variety of forward dislocationpresent. The symptoms are those mentionedpreviously as pertaining to dislocations of thehumerus. Downward Dislocation. — The truedownward or subglenoid dislocation is rare forthe reason mentioned. This form is unfortu-nately sometimes confused with the axillaryvariety of forward dislocation. Backward Dislocation.—This form of luxation is not humeral head lies upon the scapula, beneath the acromion con-stituting the subacromial variety or far back so as to be called withpropriety the subspinous variety. The elbow in this variety is rotateda little forward, though it is abducted as in other dislocations of theshoulder. It is possible in this variety to place the hand of the in-. Retroglenoid dislocation of thehumerus. (Tillmanns. ) DISLOCATIONS OF THE HUMERUS. 535 jurecl side upon the opposite shoulder while the elbow is close to thechest. Treatment.—Dislocations of the shoulder are usually reduced withoutdifficulty, if the attempt is made early and the patient etherized so as toprevent pain and relax the muscles. There are many methods, butmost of them may be referred to one of two classes : (1) The manip-ulative or rotation methods, and (2) the extension or traction following is a successful means of the first class for forward anddownward luxations :—Grasp the forearm with one hand, the arm closeto the axilla with the other ; flex the elbow, abduct the arm, making Fig. 295.
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