One of the best methods to correct typical ribs is to have the patient
upon the side with the side of the affected ribs upward. Find out
exactly the nature of the dislocation, i. e., what is the relation
of the dislocated rib to the other tissues. Note whether the rib is
upward, downward, inward or forward, locate exactly the dislocated
rib. Then, while standing back of the patient, place your fingers upon
both ends of the rib. Place your fingers in such a manner that when
the proper time in the procedure arrives, all that will be necessary
will be to push the ends of the rib into their articulations. For
instance, if the rib is raised anteriorly and lowered posteriorly,
you will place the fingers on the sternal end, above the affected
rib and the fingers on the vertebral end, below the rib, so that
when the rib has been released from its abnormal position it may be
slipped into normal position. After having placed the fingers in the
exact position necessary, have an assistant take the arm and draw it
obliquely across the face, while at the same time the patient takes a
forced inhalation. The object of drawing the arm across the face and
the deep inhalation is to exaggerate the lesion—to draw the ribs out
of their locked position—so that the fingers upon either end of the
rib may push the rib into normal position. Drawing upon the arm raises
all the upper ribs as well as the dislocated typical rib, principally
by the use of the serratus magnus; also inhalation has an effect to
throw the rib outward and upward and thus away from its articulation.
Thus after the lesion has been increased sufficiently to loosen the rib
from its abnormal position, the arm is relaxed, the patient exhales,
and the fingers upon the ends of the rib correct the dislocation. This
treatment is used to the greatest advantage when there is a dislocation
of a typical rib; it can be given while the patient is lying down or
sitting up, although the former position is preferable.
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