DISLOCATIONS In dislocations the patient cannot move the limb; there is deformity, shortening, and pain. It is usually an easy matter to diagmose a disloca tion, whereas it is often very difficult to always detect a fracture.
Treatment.—Send for a physician immediately, and while awaiting his arrival place the patient in as com fortable a position as possible. Sup port the inj ured part with pillows or bandages, and apply hot towels to the part to reduce the pain and in flammation. Dislocations are not so serious if reduced immediately before inflammation has begun seriously.
Long delay makes the work of ad justment very hard, and In severe cases the swelling must be reduced before the dislocation can be treated.
Yet, while this is true, unskilled handling may prove very serious, and where it is possible to secure a sur geon the dislocation had better re main untouched until his arrival. Where, however, a surgeon cannot be secured for several hours, an atternpt may be made to correct the disloca tion, and a few hints are given how to act.
The most common dislocation, no doubt, is that of the fingers. This occurs very frequently in games of baseball. Often the first joint of the finger is thrown out of place and is turned upward and backward. The first act in the treatment is to grasp the tip of the finger firnaly. Then in crease slightly the deformity in order to loosen the impaction; at the same time press the dislocated end into place and pull forward firmly but not roughly. When reduced, it would be
wise to use a small stick as a splint and bandage the finger, making it ab solutely immovable. Frequent baths in water as hot as can be borne will help to soothe and heat A very embarrassing dislocation is that of the lower jaw. This occurs usually in consequence of extreme yawning or sometimes in laughing. A friend of mine, an intern in a Jew ish hospital, was called several times each week to a home for the Jewish, to reduce the dislocation of the lower jaw of an old Hebrew who had the happy faculty of dislocating his jaw at very frequent intervals and often at very inopportune times. We are surprised that this occurs as fre quently as it does, but really it is still more remarkable that it does not oc cur with greater frequency among the members of the opposite sex, es pecially at the high-school age.
Where such an accident occurs the victim is found with his mouth wide open, with the saliva dripping from its corners, and unable to speak dis tinctly.
To reduce the inflammation, wind a handkerchief thickly around both thumbs, padding them well, to avoid injury by the sudden closing of the mouth when reduced. Place the thumbs on each side of the lower jaw, inside the rnouth and as far back as possible. Then press firmly downward and backward, when the jaw will be felt to slip into place. When in place, bandage to hold in position.