File:A system of surgery (1895) (14595624207).jpg

Identifier: systemofsurgery01trev (find matches)
Title: A system of surgery
Year: 1895 (1890s)
Authors: Treves, Frederick, Sir, 1853-1923
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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per-mitted. There is pain in the course ofthe crural nerve, and the head of thefemur makes a marked projection beneathPouparts ligament, which is the dis-tinguishing sign of the accident, and atonce differentiates it from fracture. Treatment.—The leg and thigh areflexed in slight abduction, and thenswept inwards in adduction until nearthe median line; rotation inwards or Fig. «srotation outwards may then be tried, thelimb being extended at the same time.By these means the head of the bone retraces its steps round theacetabulum to the inner side and below, and the final manipulationslips it into the socket. Should the head of the bone have passedfar under the crural arch, it would be right to flex the leg and thighwell, and draw or lift it downwards, until it is judged that thehead of the bone is sufficiently disengaged to move freely on mani-pulation. The different methods of manipulation advised for thisdislocation make it very probable that no one method will succeedfor all cases
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:.—Pubic Dislocation of to*Hip. 1006 DISLOCATIONS. Anomalous forward dislocations.-—The principal of these areas follows : Yery violent and continued abduction may force thehead of the femur into the perineum, where it may be felt, exercisingpressure upon the urethra. All the symptoms of obturator disloca-tions are here very exaggerated. The head of the femur has beenthrown forwards and directly upwards, and has been found restingupon the ilium, below the anterior inferior spine (subspinous). Inall such displacements the detection of the head of the bone in itsnovel position will be the best guide to diagnosis, and the treatmentcan only be conducted by carefully studying the peculiarities of eachindividual case. After consequences and after treatment of dislocations of thehip.—Should there have been extensive lesions of the soft parts,much weakness and lameness may long persist after dislocationof the hip. Should the sciatic nerve be injured, wasting of groupsof muscles, especia

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