Supracotyloid dislocation / by John Ridlon.

  • John Ridlon
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Supracotyloid dislocation / by John Ridlon. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    femoral head lias passed. In these cases the Y-Hgament lies to the front of the head of the bone, and manipulation must be directed to return the bone to the dorsal disloca- tion before attempting to bring it into the socket. The next form, second as to frequency, is secondary to an ante- rior displacement, and results from the bone passing upward and somewhat backward. Shortening may be very little or very considerable, and there is eversion, usually extreme, abduction, and some flexion of the limb; the head of the bone can readily be felt and usually seen as a prominence below the anterior superior spine of the ilium. In this dis- placement the Y-ligament lies posterior to the head of the bone, and reduction must be accomplished by first return- ing the head of the bone to the position of an anterior dislocation. The third form, that of displacement directly upward, with the Y-ligament stretched over the head of the bone, appears, from the literature on the subject which one is able to find, to be a very rare occurrence. The man ner of its production in the previously reported cases to which I have had access has been uncertain, and the ma- nipulations to be resorted to for its reduction have been based on purely theoretical grounds. From the manner of production of the dislocation in the case reported it would seem to indicate that the limb should be strongly rotated outward, moderately abducted, and extended to its fullest extent, then rapidly rotated inward, flexed, and adducted to the normal antero-posterior plane. In fully extending a limb the pelvis must be fixed, and I know of no way of doing this so effectually as by flexing the opposite thigh strongly on the trunk of the patient and strapping it there. With the patient in this position the pelvis is easily stead- ied for any desired manipulation. Onlv one further point needs to be considered—the differential diagnosis from fracture of the neck of the
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