Description of two cases of direct dislocation backwards of the femur with fracture of the rim of the acetabulum : with remarks on the mode of production of dislocations backwards / by Frederic S. Eve.

  • Eve, Frederick Samuel, Sir, 1853-1916.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Description of two cases of direct dislocation backwards of the femur with fracture of the rim of the acetabulum : with remarks on the mode of production of dislocations backwards / by Frederic S. Eve. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    probably due to this cause, and Mr. MacOormac points out that this would have occurred in his case of direct dislocation. When the margin of the acetabulum is fractured the dislocation is easily reduced by traction on the flexed and slightly abducted thigh. This manipulation was success- ful in Case 2, also in a case recently admitted to the hospital, which was believed by the majority of those who saw it, to be a direct dislocation backwards with fracture of the acetabulum. In direct dislocations below the tendon the head of the femur is returned to the socket through the cotyloid notch, the untorn portion of the capsule being, as already shown, no obstruction to reduction. In Case 1 reduction was readily effected in this manner after dissection. It is therefore evident that a dislocation cannot be assumed to be indirect because the head of the femur returns to the socket through the cotyloid notch, since a direct dislocation below the tendon, and therefore not pi'oduced by abduction, is reduced in the same manner. The rigidity of the femur in Case 1, due to the head being bound down by the obturator internus, has been already referred to. It would probably have formerly been ascribed, as Bigelow points out, to locking of the head of the femur in the sciatic notch. The principal conclusions arrived at may be stated as follows : a. That direct dislocation backwards does occur without fracture of the acetabulum. b. It is probable that direct dislocation backwards is comparatively common, and frequently associated with fracture of the rim of the acetabulum. c. That a direct dislocation above the tendon can be reduced by flexion and circumduction of the thigh, through the opening in the capsule by which it escaped. d. That the untorn inferior portion of the capsule is no obstacle to reduction in direct dislocations below the tendon.
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