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Treatment of Dislocations.It has been said in speaking of fractures, that the muscles are in a state of constant contraction, and that this contraction is increased by injury. Hence whenever a bone is fractured obliquely so that the broken ends can slide over each other, the limb is at once shortened by the action of the muscles which pull one fragment past the other. This same effect is manifested in case of dislocation ; the displaced bone is drawn upward toward the bone against which it naturally rests. To reduce the dislocation-that is, to restore the displaced bone to its natural position - we must overcome or avoid the muscular action whereby the bone is held in its natural position. In some cases this becomes an extremely difficult item of treatment; indeed in former years complicated mechanical means were used for overcoming this contraction of the muscles ; at present we accomplish the same result in simpler ways. The means for accomplishing this in the different dislocations will be discussed under the special heads ; there is, however, one means for overcoming muscular contraction, which is generally applicable, and to which surgeons often resort in order to restore displaced bones to their proper position ; this is the administration of ether. Under the influence of this substance all the muscles of the body become relaxed. In this condition dislocated bones can be replaced with much greater ease. A second feature to be considered in the reduction of a dislocation, is the position of the ligaments and tendons around the joint. When a bone is displaced, it often assumes such a position that it is separated from the cavity in which it should rest by several ligaments. If an attempt be made to restore the bone directly to its former position, its progress is opposed by these ligaments ; this opposition cannot be overcome by any reasonable degree of force, and it is furthermore not desirable that it should be overcome, since to do so, would tear and lacerate the ligaments. It is therefore necessary to avoid, so far as possible, any collision between the bones and the ligaments which surround the joint. This is accomplished by placing the bone in the position which it occupied at the moment when it was dislocated ; by so doing, the end of the displaced bone is brought opposite to the opening between the ligaments which was made at the time of its escape from its socket. A clear comprehension of the measures required by this latter principle, can be attained only by a somewhat intimate knowledge of the anatomy of the parts. While it is impossible in a work of this sort to explain details, the general facts will be mentioned in connection with the individual fractures. A dislocated bone should be restored to jts former position as soon as possible after the dislocation. In the great majority of cases the restoration of the bone can be effected without difficulty. It will not be safe for an inexperienced person to administer ether ; that is although deaths from ether are quite rare in the hands of physicians, yet in ignorant or careless hands the drug is a most dangerous one. We can sometimes accomplish in a somewhat imperfect way the result aimed at in administering ether- that is the relaxation of the muscles - in the following way: At the instant when we are ready to exert whatever force may be necessary to reduce the dislocation, we divert the attention of the patient from the operation by a sudden exclamation or by asking him a question. The muscles are relaxed for a few moments while his mind is thus fixed on the subject of the remark; if the effort be made to reduce the limb during these few moments, it will often be possible to accomplish a reduction which would otherwise baffle all attempts without ether. It is desirable to know the position of the limb at the time when the bone was displaced ; for we can generally best succeed in restoring the bpne to its former position by placing it as nearly as possible in the position which it occupied at the moment of its escape from the socket. Thus if the shoulder-joint have been dislocated by violence which raised the arm forcibly upward above the head, we can usually succeed in restoring the bone by placing the patient upon his back and drawing the elbow up above the shoulder, and by exerting a gentle force in pulling the arm in this direction. It is always necessary to have an assistant, who shall steady the joint while the operator manipulates the dislocated limb. After the dislocation has been reduced, the limb should be kept perfectly quiet for several days at least. This is necessary, not only to avoid the pain which movement would occasion, but also to afford an opportunity for the healing of the lacerated tissues around the joint. If the limb be not kept quiet, a second dislocation with additional injury to the tissues may occur. In most cases rest can be secured sufficiently by the application of bandages. Sometimes it is advisable, also, to apply a splint of leather or wood to accomplish the same purpose. If there be much pain and swelling in the joint, it is desirable to envelop the part in cloths saturated with hot water. A joint which has been once dislocated must always be treated with extreme care subsequently. No free use of the part, such as is natural to it, should be allowed in less than a month after the dislocation, and even after that, care should be taken to avoid any violent effort. 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