. A practical treatise on fractures and dislocations. by manipulation. It isas follows: 1. Inward rotation to relax the capsule and lift the head from theposterior surface of the pelvis. 2. Flexion, to a right angle and gently, preserving the existingadduction and inward rotation. 3. Traction, to make the capsule tense, so that it can be utilized inthe following movement, and to raise the head to the level o^ tlioacetabular margin, thus overcoming the action of gravitv, ^ Bigelow: Loi. cit., p. 46. ^ Volkmauus klinisehe Vwtriino. No. 63. DISLOCATIONS. 4. Outward rotation; this makes the poster
. A practical treatise on fractures and dislocations. by manipulation. It isas follows: 1. Inward rotation to relax the capsule and lift the head from theposterior surface of the pelvis. 2. Flexion, to a right angle and gently, preserving the existingadduction and inward rotation. 3. Traction, to make the capsule tense, so that it can be utilized inthe following movement, and to raise the head to the level o^ tlioacetabular margin, thus overcoming the action of gravitv, ^ Bigelow: Loi. cit., p. 46. ^ Volkmauus klinisehe Vwtriino. No. 63. DISLOCATIONS. 4. Outward rotation; this makes the posterior part of the capsuleand outer baud of the Y-ligaraent tense, and turns the head forwardinto the socket. There are a number of practical points connected with the carryingout of these directions which require attention. The pelvis may needto be steadied or immobilized during traction, in order that the limbmay not be too soon or unwittingly abducted, and this may be doneeither by the hands of assistants or by the pressure of the surgeons Fia. Reduction of dorsal dislocation of the hip by the weight of the limb. foot upon the anterior superior spinous process of the ilium of theinjured side while lie is lifting the thigh. The traction upon the thigh may be made by the hands of the sur-geon, but if the patient is a muscular adult the force that can be thusexerted may be insufficient, and it can then be conveniently supple-mented by passing a bandage tied in a long loop under the patientsflexed knee and over the surgeons shoulders; this leaves his handsfree to rotate the thigh by means of the leg. It is important to remem-ber that reduction is to be made by traction, not by manipulation, forif the thigh falls backward by its ow^n weight or is pressed back bythe surgeon while he is ^ manipulating it may seriously change itsrelations with the tissuas about it. BACKWARD DISLOCATIONS OF THE HIP. 817 A much more convenient plan, one which I have haV)itually em-ployed for many y
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
