. A practical treatise on fractures and dislocations. otating inward. Kocher3 reduced a dislocation of four weeks standing, which hadresisted all other methods, by making continuous traction in the axis 1 Bigelow : The Hip, p. Kocher : Loc. cit., p. 620. 3 Kocher: Volkruanns klin. YortrLige, No. S3. 750 DISLOCATIONS. of the limb and combining with it elastic traction laterally on theupper part of the thigh. On the morning of the fourth day reductionwas found quietly to have taken place. In a case in which the dislocation had existed for twenty monthsand the disability was great, MacCormac
. A practical treatise on fractures and dislocations. otating inward. Kocher3 reduced a dislocation of four weeks standing, which hadresisted all other methods, by making continuous traction in the axis 1 Bigelow : The Hip, p. Kocher : Loc. cit., p. 620. 3 Kocher: Volkruanns klin. YortrLige, No. S3. 750 DISLOCATIONS. of the limb and combining with it elastic traction laterally on theupper part of the thigh. On the morning of the fourth day reductionwas found quietly to have taken place. In a case in which the dislocation had existed for twenty monthsand the disability was great, MacCormac excised the head and tro-chanter with a good result. The patient was a sailor nineteen yearsold. For details of the case (see Chapter LIIL). Perineal Dislocations. The recorded cases of this form are not It is character-ized by the presence of the head more superficially placed than in theobturator variety and displaced to a greater distance from the socket,so as even in one case to press upon the urethra and interfere with the Fig. Perineal dislocation of hip. (Stimson.) voiding of the urine. In Taylors case, quoted above among compounddislocations of the hip, page 723, the dislocation was made compoundby a rent in the integument of the perineum nearly two inches long;and, possibly, Woodwards case, quoted in the same section, may belooked upon as an extreme form of this variety. The cause appears to be extreme abduction of the limb, caused inmy three cases by the fall of a heavy body upon the patients back ashe stood or knelt with the thigh flexed and abducted. Probably the1 See also a paper by Eiedenger in Munch, med. Wochenschrift, August 16, 1892. SUPRAPUBIC DISLOCATIONS OF THE HIP. 701 capsule is widely torn,and thus may be explained the varying attitudeof the Limb in respect of inversion or eversion. In an autopsy reportedby Shaw1 not only was the capsule extensively detached al it- innerand posterior insertion upon the acetabulum, out also the iliofemor
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