[p. 283]below the arm. Treatment:-As to attitude, the arm placed
by the side, the hand and shoulder raised; the bandaging and adjustment
of the parts while in this attitude. If not reduced, the top of the
shoulder becomes attenuated.
When the acromion is torn away, the appearance is the same as in dislocation
of the shoulder; but there is no impediment, except that the bone
does not return to its position. The figure should be the same as
in dislocation, both as regards bandaging and suspending the limb.
The bandaging according to rule.
When partial displacement (sub-luxation?) takes place at the elbow,
either inside or outside, but the sharp point (olecranon?) remains
in the cavity of the humerus, make extension in a straight line, and
push the projecting parts backward and to the sides.
In complete dislocations to either side, make extension while the
arm is in the position it is put in to be bandaged for a fracture,
for thus the rounded part of the elbow will not form an obstacle to
it. Dislocation most commonly takes place inward. The parts are to
be adjusted by separating the bones as much as possible, so that the
end of the humerus may not come in contact with the olecranon, but
it is to be carried up and turned round, and not forced in a straight
line; at the same time the opposite sides are to be pushed together,
and the bones reduced to their place. In these cases rotation of the
elbow cooperates; that is to say, turning the arm into a state of
supination and pronation; so much for the reduction. With regard to
the attitude in which it is to be put,-the hand is to be placed somewhat
higher than the elbow, and the arm by the side; this position suits
with it when slung from the neck, is easily borne, is its natural
position, and one adapted for ordinary purposes, unless callus form
improperly: the callus soon forms. Treatment:-By bandages according
to the common rule for articulations, and the point of the elbow is
to be included in the bandage.
The elbow, when luxated, induces the most serious consequences, fevers,
pain, nausea, vomiting of pure bile; and this especially in dislocations
backward, from pressure on the nerve which occasions numbness; next
to it is dislocation forward.