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DISLOCATION OF THE ELBOW, &c.

arti'.-.illation, as well as from its exposure to external injuries, thisbone is the most subject to dislocation of any in the body. A dis-location of the humerus may be known by a depression or cavityon the top of the shoulder, and an inability to move the arm.When the dislocation is downward or forward, the arm is elongat-ed, and a ball or lump is perceived under the arm-pit; but whenit is backward, there appears a protuberance behind the shoulder,and the arm is thrown forwards towards the breast.

The usual method of reducing dislocations of the shoulder is toseat the patient upon a low stool, and to cause an assistant to holdhis body so that it may not give way to the extension, while an-other lays hold of the arm a little above the elbow, and graduallyextends it. The operator then puts a napkin under the patient'sarm, and causes it to be tied behind his own neck : by this, whilea sufficient extension is made, he lifts up the head of the bone, andand with his hands directs it into its proper place. There arevalions machines invented for facilitating this operation, but thehand of an expert surgeon is always more safe. In young anddelicate patients, I have generally found it a very easy matter toreduce the shoulder, by extending the arm with one hand, andthrusting in the head of the bone with the other. In making theextension, the arm ought always to be a little bent.

Dislocation of the Elbow.

The bones of the fore-arm may be dislocated in any direction.When this is the case, a protuberance may be observed on thatside of the arm towards which the bone is pushed, from which,and the patient's inability to bend his arm, a dislocation of thisjoint may easily be known.

Two assistants are generally necessary for reducing a dislocationof the elbow ; one of them must lay hold of the arm above, andthe other below the joint, and make a pretty strong extension,while the operator returns the bones into their proper place. Af-terwards the arm must be bent, and suspended for some time witha sling about the neck.

Luxations of the wrist and fingers are to be reduced in thesame manner as those of the elbow, viz. by making an extensionin different directions, and thrusting the head of the bone into itsplace.

Dislocation of the Clavicle or Collar-bone.

The clavicle may be luxated at its sternal extremity,* forwards,backwards, and upwards, but never downwards, on account of thesituation of the cartilage of the first rib. The luxation forward ismost frequent, and almost the only one ever met with.

In reducing these dislocations of the sternal end of the clavicle,a lever is to be made of the arm, by means of which the shoulderis to lie brought outwards ; and when thus brought outwards, it isto be pushed forwards, if the dislocation be in that direction ;backward, if the dislocation be behind; and upward, if it be above.

The end nearest the breast-bone.