[p. 227] forward the arm
is to be bent around a ball of cloth of proper size, and at the same
But if the displacement be on the other side, both these operations
are to be performed in effecting the adjustment. For conducting the
treatment, the position and bandaging are the same as in the other
cases. But all these cases may be reduced by ordinary distention.
Of the methods of reduction, some operate by raising up the part,
some by extension, and some by rotation: the last consists in rapidly
turning the fore-arm to this side and that.
The joint of the hand is dislocated either inward or outward, most
frequently inward. The symptoms are easily recognized: if inward,
the patient cannot at all bend his fingers; and if outward, he cannot
extend them. With regard to the reduction,-by placing the fingers
above a table, extension and counter-extension are to be made by other
persons, while with the palm or heel of the hand on the projecting
bone one pushes forward, and another from behind on the other bone;
some soft substance is to be applied to it, and the arm is to be turned
to the prone position if the dislocation was forward, but to the supine,
if backward. The treatment is to be conducted with bandages.
The whole hand is dislocated either inward or outward, or to this
side or that, but more especially inward; and sometimes the epiphysis
is displaced, and sometimes the other of these bones is separated.
In these cases strong extension is to be applied, and pressure is
to be made on the projecting bone, and counter-pressure on the opposite
side, both at the same time, behind and at the side, with the hands
upon a table, or with the heel. These accidents give rise to serious
consequences and deformities; but in the course of time the part gets
strong, and admits of being used. The cure is with bandages, which
ought to embrace both the hand and fore-arm; and splints are to be
applied as far as the fingers; and when they are used they should
be more frequently unloosed than infractures, and more copious affusions
of water should be used.
In congenital dislocations (at the wrist) the hand becomes