eased, as
there is nothing to hold the bones in place; but in dislocation, after
the bones are replaced in their normal position, the deformity will
not reappear.
=Treatment.=--The treatment for dislocation consists in bending the
forearm backward to a straight line, or even a little more, and then
while an assistant holds firmly the arm above the elbow, the forearm
should be grasped below the elbow and pulled with great force away
from the assistant and, while exerting this traction, the elbow is
suddenly bent forward to a right angle, when the bones should slip
into place.
The after treatment is much the same as for most fractures of the
elbow. The arm is retained in a well-padded right-angled tin splint
which is applied with three strips of surgeon's plaster and bandage to
the front of the arm and forearm (see Fig. 33) for two or three weeks.
The splint should be removed every few days, and the elbow joint
should be moved to and fro gently to prevent stiffness, and the
splint then reapplied.
=DISLOCATION OF THE HIP.=--This occurs more commonly in males from
fifteen to forty-five years of age, and is due to external violence.
In the more ordinary form of hip dislocation the patient stands on the
sound leg with the body bent forward, the injured leg being greatly
shortened, with the toes turned inward so much that the foot of the
injured limb crosses over the instep of the sound foot. The injured
limb cannot be moved outward and but slightly inward, yet may be bent
forward. Walking is impossible. Pain and deformity of the hip joint
are evident.
The only condition with which this would be likely to be confused is a
fracture of bone in the region of the hip. Fracture of the hip is
common in old people, but not in youth or middle adult life. In
fracture there is usually not enough shortening to be perceived with
the eye; the toes are more often turned out, and the patient can often
bear some weight on the limb and even walk.
=Treatment.=--The simplest treatment is that recommended by Stimson,
as follows: the patient is to be slung up in the air in a vertical
position by means of a sheet or belt of some sort placed around the
body under the armpits, so that the feet dangle a foot or so from the
floor, and then a weight of about ten or fifteen pounds, according to
the strength of the patient's muscles, is attached to the foot of the
injured leg (bricks, flatirons, or stones may be used), and this
weight will
|