=The Elbow.=—The signs of dislocation at this joint are tolerably evident, but there is often coexistent fracture of the coronoid or olecranon processes. Separation of the articulating surfaces of the humerus from the shaft is sometimes mistaken for dislocation of the forearm backwards. In dislocation of _both bones backwards_ the olecranon is very plainly felt behind the lower end of the humerus; the sigmoid notch is generally to be made out, and the forearm is fixed at a right angle. The altered relation of the olecranon to the condyles suffices to distinguish dislocation from fracture of the humerus at its lower end, where the olecranon also goes backwards, but _the condyles go with it_. The immobility of the joint distinguishes it from separation of the lower articular surfaces of the humerus from the shaft, an accident, moreover, only met with in children. Other subordinate distinctions between dislocation and fracture are, the limited movement, the difficulty of restoring the bones to their natural position, and the absence of crepitus; lastly, the peculiar form of the articular surfaces can sometimes be made out. In reducing the _backward dislocations_ the patient sits on a chair on which the surgeon rests his foot, pressing his knee against the forearm at the elbow for a fulcrum; then, grasping the wrist with one hand, and steadying the arm with the other, he flexes the elbow to dislodge the coronoid process from the fossa at the back of the humerus; when this is done, the articulating surfaces slip into place. This plan is commonly adopted when the olecranon is displaced, but if it fails to reduce the dislocation, direct extension at the wrist must be employed, as for the following dislocation. When the _radius only_ is displaced, the body should be fixed by a jack towel carried under the armpit of the injured side, and over the shoulder of the sound side. A wetted bandage is rolled round the forearm, and a second towel is attached by a clove-hitch (see fig. 62, page 99) to the wrist for extension, which is made in the axis of the limb until the radius can be slipped into its place on the outer condyle. [Illustration: Fig. 64.—Reducing dislocation of the elbow round the knee.] In all dislocations of the elbow, when the bones are returned the limb should be bent to a right angle and put on a lateral angular splint for a week or ten days, after which time it should be worn in a sling a fortnight longer. [Illustration: Fig. 65.—Handle for obtaining grasp of the thumb in dislocation.]