Part 20
Dislocation at the hip-joint occurs in four modes, inward most frequently,
outward next, the others of equal frequency. The symptoms:-The common,
a comparison with the sound leg. The peculiar symptoms of dislocations
inward; the head of the bone is felt at the perineum; the patient
cannot bend his leg as formerly; the limb appears elongated, and to
a great extent, unless you bring both limbs into the middle space
between them in making a comparison of them; and the foot and the
knee are inclined outward. If the dislocation has taken place from
birth, or during one's growth, the thigh is shortened, the leg less
so, and the others according to the same rule; the fleshy parts are
atrophied, especially on the outside. Such persons are afraid to stand
erect, and crawl along on the sound limb; or, if compelled, they walk
with one or two staves, and bear up the affected limb; and the smaller
the limb so much the more do they walk. If the accident happens to
adults the bones remain of their proper size, but the flesh is wasted,
as formerly described; the patients walk in a wriggling manner, like
oxen; they are bent toward the flank, and the buttock on the uninjured
side is prominent; for the uninjured limb must necessarily come below
that it may support the body, whilst the other must be carried out
of the way, as it cannot support the body, like those who have an
ulcer in the foot. They poise the body by means of a staff on the
sound side, and grasp the affected limb with the hand above the knee
so as to carry the body in shifting from one place to another. If
the parts below the hip-joint be used, the bones below are less atrophied,
but the flesh more.
