The only condition with which this would be likely to be confused is a fracture of bone in the region of the hip. Fracture of the hip is common in old people, but not in youth or middle adult life. In fracture there is usually not enough shortening to be perceived with the eye; the toes are more often turned out, and the patient can often bear some weight on the limb and even walk.
Treatment.—The simplest treatment is that recommended by Stimson, as follows: the patient is to be slung up in the air in a vertical position by means of a sheet or belt of some sort placed around the body under the armpits, so that the feet dangle a foot or so from the floor, and then a weight of about ten or fifteen pounds, according to the strength of the patient's muscles, is attached to the foot of the injured leg (bricks, flatirons, or stones may be used), and this weight will usually draw the bone down into its socket within ten or fifteen minutes.
Fig. 34.
REDUCING DISLOCATION OF HIP (Reference Handbook).
Patient lying on table; uninjured leg held by assistant; leg of dislocated side at right angles; note weight at bend of knee.
Or the patient may assume the position shown in the accompanying cut, lying prone upon a table with the uninjured leg held horizontally by one person, while another, with the injured thigh held vertically and leg at right angles, grasps the patient's ankle and moves it gently from side to side after placing a five-to ten-pound sand bag, or similar weight of other substance, at the flexure of the knee. When the dislocation has been overcome the patient should stay in bed for a week or two and then go about gradually on crutches for two weeks longer.
SURGICAL DRESSINGS.—Sterilized gauze is the chief surgical dressing of the present day. This material is simply cheese cloth, from which grease and dirt have been removed by boiling in some alkaline preparation, usually washing soda, and rinsing in pure water. The gauze is sterilized by subjecting it to moist or dry heat. Sterilized gauze may be bought at shops dealing in surgeons' supplies and instruments, and at most drug stores. Gauze or cheese cloth may be sterilized (to destroy germs) by baking in a slow oven, in tin boxes, or wrapped in cotton cloth, until it begins to turn brown. It is well to have a small piece of the gauze in a separate package, which may be inspected from time to time in order to see how the baking is progressing, as the material to be employed for surgical purposes should not be opened until just before it is to be used, any remainder being immediately covered again. Cut the gauze into pieces as large as the hand, before it is sterilized, to avoid cutting and handling afterwards. Gauze may also be sterilized by steaming in an Arnold sterilizer, such as is used for milk, or by boiling, if it is to be applied wet. Carbolized, borated, and corrosive-sublimate gauze have little special value.
| Fig. I. | Fig. II. |
| Fig. III. | Fig. IV. |
Plate I.