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A practical treatise on fractures and dislocations . ep the head of the femur across below the socket. No danger need beapprehended from this expedient of circumduction. The added injury is a veryslight one Such additional laceration may sometimes advantage-ously occur without the knowledge of the surgeon during unsuccessful efforts toreduce the bone, especially in executing the manoeuvres described in the rule :flex, abduct, evert. The advantages of this method may be thus stated : Flexion relaxes the ilio-femoral ligament, and the relaxation may be further increased by slight adduc-tion ; th
A practical treatise on fractures and dislocations . ep the head of the femur across below the socket. No danger need beapprehended from this expedient of circumduction. The added injury is a veryslight one Such additional laceration may sometimes advantage-ously occur without the knowledge of the surgeon during unsuccessful efforts toreduce the bone, especially in executing the manoeuvres described in the rule :flex, abduct, evert. The advantages of this method may be thus stated : Flexion relaxes the ilio-femoral ligament, and the relaxation may be further increased by slight adduc-tion ; then rotate very slightly inward, that is to say, move the foot away fromthe middle line while the knee is held steady; this disengages the head frombehind the socket; slight traction in the line of the femur will then usuallybring the bone into position ; if more force is required, the surgeon may placehis foot, covered with a stocking, on the anterior superior spinous process, tosteady the pelvis while he raises the bent knee. (Fig. 451.) Fig. Reduction by lifting. Dr. J. E. Kelly2 fixes the patient in the recumbent position by straps or band-ages around the hips and the board on which he lies; the thigh being bent atright angles with the body, the surgeon stands astride the leg facing the patient;stooping and passing his arms under the leg near the knee, the leg is broughtagainst his perineum, and he is able to lift to great advantage. (Fig. 452.)] 1 London Lancet, June 15, 1878. Dublin Journ. Med. Sci. 45 706 DISLOCATIONS OF THE THIGH The following case, reported by Dr. Fanning, of Catskill, N. Y., illustratesthe occasional necessity of resorting to extension, and is of special interest onaccount of the extreme youth of the patient. I have referred to the same caseonce before. A little girl, two and a half years old, was caught under a fallingdoor; her parents suspected no injury beyond a severe bruise until ten days Fig. 452.
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Keywords: ., bookcentury1800, bookdecade1890, booksubjec, booksubjectfractures