Fig. 362
Illustrating various types of dislocation at the hip. (Lejars.)
During the practice of this or any other method the pelvis should be firmly held in place by assistants, who may seize it with the hands and hold it down. If the patient lay upon the table the pelvis may be bound to it. The surgeon may need help in making a sufficient degree of traction. This can be furnished by a strong loop passed under the patient’s knee and over the surgeon’s shoulders, the hands thus remaining free for manipulation, traction being the most important feature.
Stimson accomplishes the same purpose by placing the patient, face downward, upon a table, the dislocated limb hanging downward as represented in [Fig. 363]. Traction is here partly affected by the weight of the limb, while in some instances the surgeon has to wait only for the muscles to relax and the bone to resume its place without much further effort than a slight rocking or rotation. Stimson claims that this often succeeds without anesthesia, and sometimes so quietly that there is scarcely any jar or sound to indicate the effection of the reduction.
Fig. 363
Reduction of dorsal dislocation of the hip by the weight of the limb. (Stimson.)
In those forms of dorsal dislocation which are accompanied by eversion instead of inversion it is necessary only to convert them into the ordinary dorsal type before proceeding as above.