Fractures and dislocations / by T. Pickering Pick.

  • Thomas Pickering Pick
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Fractures and dislocations / by T. Pickering Pick. Source: Wellcome Collection.

    507/548 (page 495)
    motion to the bones of tlie foot, and will generallj succeed in restoring them to their natural position. He must not, however, expect them to recede into their normal state mth a sadden and audible snap j as ill most other dislocations, the reduction will be etJected gradually, and he must judge of its accom- plishment by the restoration of the limb to its proper contour and appearance. Should the slightest dithculty be experienced, or the patient be nervous or complain of pain, it is advisable to administer an ansesthetic, and this will much facilitate the efforts of the surgeon. On many occasions where there has been difficulty in effecting reduction, or afterwards in maintaining the parts in proper apposition, I have found the greatest possible advantage from dividing the tendo Achilles. After reduction a pair of side splints, or if there is much swelling, a junk splint, should be applied, and when consolidation has advanced to some extent and all bruising disappeared, a fixed immovable apparatus can be worn until union has taken place. If any difficulty should arise in keeping the parts in position, the special treatment, as recommended by Pott or Dupuytren (page 288), should be adopted. Aiitero-}>osterior dii^locatsoBi of tSae ankle. —The antero-posterior dislocations of the ankle joint are not nearly so common as the lateral ones. The tarsus may be displaced either forwards or back- wards. One would be inclined to believe, from the configuration of the joint, the mortise between the malleoli being wider in front tlian behind, and the articular .surface of the astragalus being correspondingly shaped, that dislocation forwards would be a more common accident than dislocation backwards. The reverse, however, is the case. Dislocation l^ackwards does occasionally occur, whereas the forward one is of very rare occurrence. Sir Astley Cooper states that he never saw a case. This greater frequency of the