DISLOCATION OF THE FEMUR. 



57 



wards and downwards, into the foramen ovale (Fig. 15) ; 3d, back- 

 wards and downwards, into the ischiatic notch (Fig. 16); 4th, 

 upwards and forwards, on the horizontal ramus of the pubes (Fig. 

 17) ; 5th, downwards, under the tuberosity of the ischium. The 

 first is the most common, the filth is the most rare. 



In the most frequent displacements upwards avd backwards^ the 

 limb is shortened from an inch and a half to two inches and a half ; 

 the toes rest on the opposite instep ; the knee is turned inwards and 

 slightly bent ; the limb may be bent across the other, but cannot be 

 moved outwards ; the trochanter is less prominent, and nearer the 

 spine of the ilium ; and if the patient is thin, and there is no swelling, 

 the head of the bone can be felt in its new position, and the rounded 

 form of the hip is lost. It is to be distinguished from a fracture of 

 the neck of the bone by the position of the foot and the rigidity of 

 the limb. 



The reduction is the most difficult of all dislocations, and must be 

 attempted as soon as possible after the displacement. If it is not 

 produced, the head of the bone will adapt itself to its new position 

 by the formation of a tiqw cavity, and the patient will gradually be 



5* 



