The Seaman's Medical Instructor: In a Course of Lectures on Accidents and Diseases Incident to SeamenFalck, N. D. (Nikolai Detlef)
Science
The Seaman's Medical Instructor: In a Course of Lectures on Accidents and Diseases Incident to Seamen
Falck, N. D. (Nikolai Detlef)
First aid in illness and injury -- Early works to 1800; Medicine, Popular -- Early works to 1800
The thumb, however, is liable to be dislocated, which is easily
perceived; which should be immediately reduced, and secured with a
bandage, and treated as already directed.
_Dislocation of the Thigh Bone._
The articulation of the thigh bone with the hip is similar to the
shoulder, with regard to the head of the bone, and the pan in which it
moves, except that it is much deeper. It must be a great force that
drives it out of its articulation, and consequently very difficult to be
reduced. It may either be dislocated inwards, or backwards.
If the dislocation is inwards, which is the most common, the toes will
be turned outwards, and the whole leg and thigh will be somewhat shorter
than the other; so likewise, if it is dislocated backwards, the leg and
thigh will appear shorter, but the toes will be bent inwards. The best
way of determining, as I have said before, is to make a just comparison
of the sick and sound leg.
The reduction is somewhat difficult, and will sometimes baffle the most
experienced surgeon, because the acting muscles are very strong; and
when they have first begun to contract the parts, they will not easily
suffer themselves to be relaxed. Nevertheless, lay the patient upon his
back or on the sick side, upon a steady table; let an assistant hold him
fast, another extend the thigh, so as to have the knee bent; the
operator having a napkin resting on his neck, and under the thigh of the
patient, similar to the method directed before by the shoulder; and then
with both hands bend the thigh, as with a lever, into its socket again;
when it will give a loud snap, coming into its proper place.
It very frequently happens in this heavy dislocation, that either the
articulation is not reduced, or that it immediately slips out again when
reduced; so that the patient will never recover the former use of that
limb more. In this case nature is very kind, and the part where the bone
slips into will become callous, and form as it were a new acetabulum; by
which the patient in time comes to walk, though (as it may be supposed)
but lamely. In the course of my practice I have met with but two perfect
dislocations of the thigh, both of them perfectly recovered; but it must
be remembered, they had youth on their side, and the greatest care
joined to favourable circumstances.
At best however, it is an ugly accident, for it is not only that the
ligaments that surround the joint are generally torn, but very often the
thigh bone is fractured at the same time. It requires more skill than
one would suppose, to determine which is the case, whether a fracture,
dislocation, or both; and am apt to believe they are often confounded
with each other.
When the dislocation is reduced it should be well secured with a long
double-headed bandage; the patient kept still, the part well fomented,
and if requisite, some blood taken away: a fever generally attends,
which should be duely taken care of.
Public-domain text, read in full here on John Shaqi.
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