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Show DISLOCATIUN 01" THE THIGH BONE. ammonia}: or Tm: rmcn‘ BONE. 193 may feel and observe the position of the dislocated bone. A sheet is to be folded so that it may be laid upon the peri« A, the hack ofthe ilium ; B, the thyroid hole ; C, the ar'cfa‘ 13:11qu left empty; D, the head ofthefcmur; E, the trorhanter major; F, the shaft of the thigh bone. The limb operating like a long lever is here also the cause of dislocation. When a man is pushed down on his side, and the haunch strikes the ground; when carrying a heavy burthen he falls down with the leg and thigh obliquely under r" I... npy‘j, -WW"." ""‘ ,i "a, .a». ‘" him ; or, when, in riding, the horse falls on his side, and the rideu‘s thigh is under the horse, the ligaments of the hip joint. may be burst up, and the thigh bone dislocated. I have found a man who had been buried under a bank of earth with his thigh bone thus dislocated upwards and outwards ; though most frequently I am inclined to believe the head of the thigh bone will be dislocated downward, if displaced at all in these circumstances. [Manner of reducing the thigh bone when dislocated upwards, If in an hospital, the patient is to be laid on a strong table, which is screwed to the floor; folded blankets are to be placed under him ; a soft compress is put in the perineum ; if the right thigh bone be dislocated then the patient is to be on his left side, or so that he may rest on the left hip, and that we neum, and its ends tied firmly to the table. A quilted strap is to be laid betwixt the spinous process of the os ilium and the head of the thigh bone, and the ends of this are to be fixed to the sheet. The strong leather band with hooks, (which are to be found in the shops for this purpose,) are to be placed above the knee that they may take hold of the thigh bone above the condyles*. But we may have to reduce the dislocated thigh bone when we have no hospital apparatus, and therefore we must think of our means when in a private chamber. We first fix the bed, then wrap around the bed post a sheet or blanket. The patient being laid on the bed with his thighs on each side of the post, he is then to lie down inclined towards the opposite side from that which is to suil‘er the operation. In this position when the pull is made on the dislocated thigh the tuber ischii and perineum are made to press against the bed post. The patient's body is to be kept down in this position by an assistant. It is the duty of this assistant at the same time to observe that the pelvis and trunk do not move upon the sound hip joint ; for which purpose he has to lay himself on the bed, and keep hold upon the spine of the patient's ilium. The laques or hitches, may be made of hand-towels, and placed above the knee, so that they take hold of the condyles of the thigh bone. The knee is to be bent, and the leg and foot used as a lever to move the head of the bone. in a rotatory manner. It is said, that when one of the towels is brought on the inside of the knee this rotation is impeded. I do not remember to have experienced any dilhculty in reducing a dislocated thigh in this manner, though it had continued unreduced for three weeks. At the same time, if we consider the direction of the force to be employed, and the position of * In cases of dislocation where much force is to be used, a few turns of a flannel roller should be put round the limb before fixing this apparatus. VOL. n. B2 -‘ V'fi "WM‘ vmm M9221: ‘ |