. The principles and practice of modern surgery. rds if both bones be dislocated, or twisted if only one be displaced,—and by the alteration of the natural relative position of the styloid pro-cesses of the radius and ulna with the bones of the carpus. They arereduced by simple extension.* VI. Dislocations of the Hand.—The os magnum and os cuneiformeare sometimes partially dislocated through relaxation of their ligaments,and form projections at the back of the hand, which must not be mistakenfor ganglia. Mr. Fergusson has also known the os pisiforme dislocatedby the action of the flexor carpi
. The principles and practice of modern surgery. rds if both bones be dislocated, or twisted if only one be displaced,—and by the alteration of the natural relative position of the styloid pro-cesses of the radius and ulna with the bones of the carpus. They arereduced by simple extension.* VI. Dislocations of the Hand.—The os magnum and os cuneiformeare sometimes partially dislocated through relaxation of their ligaments,and form projections at the back of the hand, which must not be mistakenfor ganglia. Mr. Fergusson has also known the os pisiforme dislocatedby the action of the flexor carpi ulnaris muscle. Treatment.—Cold affiision, friction, and mechanical support. Dislocations of the thumb, fingers, and toes, are difficult of reductionin consequence of the strength and tightness of their lateral ligaments,and the small size of the part from which extension can be made. Afirm hold may be obtained by means of a piece of tape fastened with theknot called the clove hitch, represented in this figure. But it is a good Fig. 76. .. * Dupuytren taught that these dislocations are extremely rare, or, in fact, almost impos-sible; and that fractures of the lower extremity of the radius were generally mistaken forthem. But the experience of English surgeons shows that real dislocation, without any frac-ture, is not by any means unconunon. See a very carefully reported case in the Lond. , June 17th, 1843. 274 DISLOCATIONS OF THE HIP. plan to place a part of the tape round the head of the dislocated bone,so as to pull it straight forwards into its place. Extension should bemade towards the palm, so as to relax the flexor muscles. But beforethe reduction has been effected, says Mr. Liston, it has been in somecases even found necessary to divide one of the ligaments; the externalis most easily reached; it is cut across by introducing a narrow-bladedand lancet-pointed knife through the skin at some distance, and directingits edge against the resisting part. In compou
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