Synopsis
This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1890 Excerpt: ...more or less completely in either direction, and rests Oq the outer side of the external condyle, or the inner side of the internal condyle, of the femur. Signs.--An unnatural swelling--the projection of the patella--can he een and felt over the outer or inner condyle, with an unnatural depression m front of tho knee, owing to the absence of the bone from its proper itaatioa. The knee is much broader than usual, slightly bent, and immovable; considerable pain also is experienced, especially aggravated by iay attempt to bend the joint. Causes.--Muscular contraction of the triceps extensor would seem to be the usual cause of these dislocations. The outward displacement is t ulicularly liable to occur in persons who are knock-kneed, or whose external condyle has not the usual degree of prominence anteriorly. Dislocation of the patella in this direction may sometimes be produced voluntarily. Displacement may arise from distension of the joint with tynovialfluid. Indirect violence is sometimes the cause; as a sudden twist of the thigh inwards, while the weight of the body resting on the foot,keeps the leg turned outwards; or a fall with the knee turned inwards, iml the foot outward. Direct violence, as a blow upon the inner or outward margin of the patella, may sometimes produce dislocation outwards or inwards, respectively. These dislocations are very apt to recur. Treatment.--Heduction is easily accomplished. But although perpetually recurring, or even remaining unreduced in a few cases, the use »( the limb may be almost unimpaired. Tho patient lying on his back, the Surgeon raises the thigh towards the abdomen, so as to relax the triceps extensor muscle; and then by pressing the patella inwards, or outwards, over the condyle, it is at once drawn into pla...
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