The Articulations 351 



ture of the ligaments of a joint but unattended with displacement of 

 the articular surfaces. It is often accompanied with injury to the 

 neighboring parts. It is generally produced by external violence, 

 such as a blow or fall, but may be caused by a sudden twist of the 

 joint during rapid progression. There results an increase of 

 synovial secretion and consequent distension of the sac, or hemorr- 

 hagic extravasation, according to the degree of injury sustained. 

 The condition may become chronic owing to incomplete absorption 

 of the inflammatory products, imperfect repair of the torn liga- 

 ments, or periarticular fibrous ankylosis. The round ligament of 

 the hip joint is a common seat of sprain. 



Symptoms and Diagnosis. The lesion is recognized by the fol- 

 lowing symptoms: local tumefaction and pain particularly on pres- 

 sure being applied, and pronounced limping or inability to bear 

 weight on the leg. Absence of crepitus or modification of the out- 

 lines and length of the member serve to distinguish a sprain from 

 a fracture or dislocation, though very often the swelling is so great 

 as to render it difficult or impossible to make a diagnosis until the 

 former has subsided. 



Treatment. The indications are to enforce complete rest, and 

 where possible to secure immobilization of the joint by bandages. 

 A stream of cold water from a hose repeated several times daily 

 is beneficial. Resolution takes place usually in from one to two 

 weeks. Chronicity is recognized by persistent limping, in which 

 case external painting with tincture of iodine may be tried. 



Luxations. Dislocations. 



LUXATIONS IN GENERAL 



These terms are employed when the articular ends of one or 

 both bones are displaced from their normal position. There are two 

 principal types — the Traumatic and the Congenital. Tk« first results 

 from direct or indirect violence while a dislocation is said to be 

 congenital when from errors or failure in development the normal 

 contiguity of articular surfaces cannot be maintained. A luxation 

 may also result from relaxation of ligaments owing to constitu- 

 tional debility, or from pathologic changes in ligaments or tissues 

 entering into the formation of a joint. 



