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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    Case 2.—Wm. J—, set. 55, was admitted to St. Bar- tholomew's Hospital under care of Mr. Willett, to whose kindness I am indebted for permission to communicate the case. Whilst at work excavating_, a large fall of earth took place upon him. On admission he was much collapsed and com- plained greatly of pain in the abdomen. The left hip presented the ordinary appearances of sciatic dislocation. No attempt at reduction was made on the day of the accident, owing to the collapsed condition of the patient, but the following day he was placed under an angesthetic and an attempt made to effect reduction by the ordinary manipulation. This failing, Mr. Willett slightly flexed and adducted the thigh, and on applying slight traction the head at once returned to the socket. From this circumstance Mr. Willett inferred that it was a case of direct dislocation backwards, probably with fracture of the margin of the acetabulum. Symptoms of peritonitis appeared, and the patient died the next day. The post mortem examination revealed intense general peritonitis due to the rupture of a portion of intestine, which lay apparently in the right inguinal canal at the time of the accident. The hip was handed over to me for dissection. The following is a description of the preparation ^ shown. (See Woodcut, Fig. 2.) The gluteus maximus and medius have been removed; the lower part of the gluteus medius is reflected. The external rotator muscles are cut across and reflected. The posterior portion of the rim of the acetabulum is broken off and upturned. There is a corresponding rent in the capsule, which has been torn through at its acetabular insertion. The rent extends downwards to within one inch of the cotyloid notch, here it passes upwards and forwards towards the femoral attachment, leaving a narrow tongue- shaped portion of capsule still adherent to the inferior ' In the Museum of St. Bavtliolomew's Hospital, Series III, No. 158.