An excellent method, when the =sternal end= of the rib is dislocated
is to have the patient sit upon a stool with his back toward the
physician; then by placing the knee in the back (while standing up, or
easier still for the physician to sit upon an operating table back of
the patient) over the vertebral end of the rib so that the rib may be
held rigid posteriorly, reach around with one hand over the dislocated
end of the rib and place the fingers upon the rib in the direction
dislocated; so that when the rib is sufficiently released from its
abnormal position it can be readily pushed into place; then with the
other hand under the axilla of the arm on the affected side, pull up
and back on the shoulder, so that the rib may be pulled away from its
sternal articulation; and at the same time have the patient take a
deep inhalation so as to aid in throwing the rib outward, upward and
away from its sternal attachment; then when the end of the rib has
been released sufficiently, relax the hold underneath the axilla, have
the patient exhale, and slip the rib into its normal position by the
fingers over the end of the rib. This is an excellent method. It is
easy to give and does the work admirably.
Practically the same procedure may be gone through when the =vertebral
end= is dislocated, by changing your position to the front of the
patient, but there is danger of the knee slipping off from the sternum
during the operation and injuring the ribs. Several other treatments
may be given to correct dislocations of the vertebral ends of the ribs.
For example, while the patient remains sitting the osteopath stands
in front of the patient and reaches around both sides upon the angle
of the ribs; then with an outward and upward movement of the fingers
upon the angle of the ribs, they are pulled away from their locked
position and allowed to slip into normal articulation. This treatment
is applicable only when the ribs are dislocated downward, but it is one
of the best treatments for such cases.
Another method oftentimes employed in correcting dislocations of the
vertebral end of the ribs is to have the patient lie flat upon the
side with the affected side upward; then by flexing the arm on the
forearm and placing the elbow against the chest or abdomen reach over
the patient upon the angle of the dislocated rib and pull it away
from the vertebra; when it is pulled away from the spinal column
sufficiently, push upward or downward on the angle of the ribs, as the
case may demand. The elbow placed against you gives complete control
of the patient and aids, by your weight, in throwing the rib upward or
downward.
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