A practical treatise on fractures and dislocations . ecommends to extend forci-bly, and then suddenly flex the arm ; in a manner verysimilar to the plan recommended by Batchelder in dis-locations forward. In Dr. Freemans case, just quoted,the reduction was effected while the forearm was pro-nated, and supination seemed to throw it again out ofplace. Dr. Middleditch, in the case reported by Mack,succeeded in his first effort by making extension withthe arm flexed to a right angle, while pressure wasmade upon the head of the radius. According to Mar-koe, where the accident is complicated with a
A practical treatise on fractures and dislocations . ecommends to extend forci-bly, and then suddenly flex the arm ; in a manner verysimilar to the plan recommended by Batchelder in dis-locations forward. In Dr. Freemans case, just quoted,the reduction was effected while the forearm was pro-nated, and supination seemed to throw it again out ofplace. Dr. Middleditch, in the case reported by Mack,succeeded in his first effort by making extension withthe arm flexed to a right angle, while pressure wasmade upon the head of the radius. According to Mar-koe, where the accident is complicated with a fractureof the inner condyle, when the reduction is accomplishedthe arm should be placed in a position about ten degreesless than a right angle, and supported by a splint withbandages, etc. If the dislocation is simple, however, I can see no objection to its being nearlyor quite extended, since in this dislocation the action of the biceps would onlytend to retain the head of the radius in place. § 3. Dislocations of the Head of the Radius Dislocation of thehead of the radiusbackward. Denuce has collected four examples of this accident, unaccompaniedwith a fracture, and he proceeds to speak of it as a distinct form of dis-location. In two of the examples, however, mentioned by him, it wasconsecutive upon a forward dislocation, and I have several times seen thehead of the radius very much inclined outward in what are properlytermed forward dislocations. For these reasons it is not very plain tome that we ought to consider this as a distinct form of primary disloca-tion ; but it would seem that we ought rather to regard it as a consecu-tive dislocation, or at least as only a modification of the forward orbackward dislocation. Indeed, I think the radius never will be found Fig. 399. A DISLOCATIONS OF HEAD OF RADIUS OUTWARD. 625 thrown directly outward, but always in a direction inclining forward orbackward. Parker, of this city, mentions a case which came under his notic
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