of carrying the one piece of bone over the other, some by extension,
and some by rotation: these last consist in rapidly turning the arm
to this side and that.
The joint of the hand is dislocated inward or outward, but most frequently
inward. The symptoms are easily recognized; if inward, the patient
cannot at all bend his fingers, but if outward, he cannot extend them.
Reduction:-By placing the fingers above a table, extension and counter-extension
are to be made by assistance, while, with the palm of the hand or
the heel on the projecting bone, one presses forward, and from behind,
upon the other bone, and lays some soft substance on it; and, if the
dislocation be above, the hand is to be turned into a state of pronation;
or, if backward, into a state of supination. The treatment is to be
conducted with bandages.
The whole hand is dislocated either inward, or outward, but especially
inward, or to this side or that. Sometimes the epiphysis is displaced,
and sometimes there is displacement (diastasis) of the one bone from
the other. Powerful extension is to be made in this case; and the
projecting part is to be pressed upon, and counter-pressure made on
the opposite side: both modes being performed at the same time, both
backward and laterally, either with the hands on a table, or with
the heel. These accidents give rise to serious consequences and deformities;
but in time the parts get so strong as to admit of being used. The
treatment consists of bandages comprehending the hand and forearm,
and splints are to be applied as far as the fingers; when put in splints,
they are to be more frequently loosed than in fractures, and more
copious allusions of water are to be used.
In congenital dislocations the hand becomes shortened, and the atrophy
of the flesh is generally on the side opposite the dislocation. In
the adult the bones remain of their proper size.
The symptoms of dislocation of the finger are obvious, and need not
be described. This is the mode of reduction:-By stretching in a straight
line, and making pressure on the projecting part, and counter-pressure,
at the opposite side, on the other. The proper treatment consists
in the application of bandages. When not reduced, the parts unite
by callus outside of the joints.