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.

    437/548 (page 425)
    reduction process must have for its object, first, to restore the dislocated bone to its primary position, and thence to eflect its return. There can be no doubt that this is the simplest form of explanation which can be adopted, and Mr. Mori-is has brought forward some cogent arguments, and has so ably reasoned his case, that he almost carries conviction in the minds of his readers. But, as Mr. Rivington justly observes, the true history of dislocations of the hip joint can scarcely be written only from anatomy and experiments on the dead subject, but from these in combination with faithful records of a large number of cases. There is no doubt that in abduction of the limb the gi'eatest strain is thrown on the capsular ligament; that when the thigh is adducted the head of the bone impinges on the strongest and deepest j^art of the acetabular cavity, and very little strain has to be borne by the capsular ligament; but that when the thigh is abducted, owing to the shallowness of the lower and inner part of the cotyloid cavity, the head of the bone bulges over its margin, and a severe strain is thrown upon the capsular ligament at its lower and inner pai-t. And, moreover, anatomy undoubtedly teache.s us that this is the weakest part of this liga- ment ; that the capsule is thick and strong behind and above, and especially in front, but that it is thin and comparatively weak below and internally, at that part, in fact, where the head of the bone presses during abduction, especially if combined with tlexion and inward rotation. In consequence of this condition it can be proved experimentally that dislocation on the dea/1 subject can only be produced by teai'ing this weak part of the ligament, that is to say, by abduction of the limb, and that no force which can be applied • Bril. awl F'ir. Meil.-Chir. Rev., vol. ii., p. 540; 1857. + Lrxncet, vol. ii., p. 321; 1878.