DISLOCATION (Fr. diRlocatimi, from )11... fliselooare, to dislocate, from I.at. ills-, apart + li corc. to place, from place). .\ displace ment of one bone from another with which it forms a joint Clint out of joint' being the popu are generally the result of accident, but may also be the result of disease, or may be congenital. The displacement Wray be partial or complete, and surgeons classify their cases into $dniple disloeations when the skin remains unbroken. and compound when there is a wound by which the external air may com municate with the joint. Occasionally. in addi tion to the dislocation, there are fractures of the bones, or lacerations of important blood-ves sels in the neighborhood: the dislocation is then said to he 'emnplieated; Dislocation is II rare accident in infancy and in old age; because in the former the joint•ends of the aro very flexible and yield to violence. while the aged skeleton is so rigid that the brittle bones frac ture under force that would drive younger and firmer ones out of their sockets. Dislocations are most frequent bet Wren the ages of thirty and sixty. Persons with weak. muscles. and lax. long ligaments. or those in whom the latter have been softened by inflammation of the joint, are pre disposed to dislocation. The joints most fre quently displaced are the 01(1111,1er and the elbow.
ENElt I. SY.NIPTONIS. Alter a blow, fall, or violent muscular exertion, a limb is found to be immovable at the injured ; there is great pain, and the shape of the part is ..lounged: but soon smelling and everts mark about it is obscured. If left alone. or inerely treated as an inflamed joint, the swelling gradu ally subsides, hut the immobility continua, the limb is crippled for months or years, when at last Nature may form a new so•t:et for the end of the bone, and some amount of useful motion is restored. The proper shape of the part is never
restored. hut remains an eyesore to the patient and a disgrace to the surgeon.
TRE.‘Tatt:Nr. The general treatment of dish, eations consists in reduction or replacement of the bone into its original position. It, return is opposed by the muscles attached to it, which are stimulated to contraction by the pain of the operation, the latter requiring, of course, the application of considerable force. Pteduction is accomplished Ly two methods — man i pulat ion and traction. In using the former the surgeon endeavors first to relax those imiseles which by their contraction prevent the return of the brad of the bone into its proper position. and then by certain movements to cause the hone to retrace the path by which it escaped from the socket. \\*hen manipulation is unsuccessful. the attempt is made to overcome the resisting power of the aniseles by inictiun. 1Vhen ibis is fulls the Lone usually slips easily into its place, with per haps some guidance from the hand of the stur geon. Too great violence in traction. however, mist never be used, as injury to surrounding tissues, or fracture. may result. In eases which do not readily amestliesia must be re sorted to in order to produce complete nnitseular rola xa The subservient treatment consists in rest, with splints or bandages to prevent a recurrence of the dislocation while the relit in the joint-cap stile is healing. Four to six weeks are usually necessary for the aceomplishment of this proe css. The treatment of congenital and patholog ical dislocation is palliative. and requires the use of special apparatus., although at I operation may given new and serviceable joint.