xtended limb are
to be avoided, as they fail to meet the primary indication of relaxing
the [inverted Y]-ligament.

After reduction, the limb is steadied by sand-bags; massage is carried
out from the first, and movement after a few days. The range of
movement is gradually increased, and the patient is allowed to use the
limb with caution in from two to three weeks.

When the rim of the acetabulum has been fractured, the patient must be
confined to bed with extension for six to eight weeks, to avoid the
risk of re-dislocation.

Changes of the nature of chronic arthritis are liable to occur in and
around the joint in old and rheumatic subjects; and atrophy or
paralysis of muscles may follow, if their nerves are implicated.

#Old-standing Dislocation.#--It is impossible to lay down any
time-limit for attempting reduction in old-standing dislocations of
the hip. Manipulation may succeed in cases of some months' standing,
and may fail when the bone has been out only a few weeks. In certain
cases, even after reduction has been effected, there is a marked
tendency to re-displacement. In any case, the attempt does good by
breaking down adhesions, provided no undue force is employed such as
may damage the sciatic nerve or vessels, or fracture the neck of the
femur, and success may attend on a second or even a third attempt at
intervals of from three to five days. If manipulation fails, and if
the deformity is great and the usefulness of the limb seriously
impaired, an attempt may be made to effect reduction by operation; the
operation, however, is one of considerable difficulty, and in the
event of failure the head of the bone should be excised. If the head
has formed a new socket for itself and there is a fairly useful joint,
the condition should be left alone.

_Congenital dislocation of the hip_ is described with Deformities of
the Extremities.

#Sprain# of the hip is comparatively rare. It results from milder
degrees of the same forms of violence as produce dislocation. The
ligaments are stretched or partly torn, and there is effusion of fluid
into the joint. Pressure over the joint elicits tenderness; and the
limb assumes the position of slight flexion, abduction, and lateral
rotation, but there is no alteration in length. Such injuries, unless
carefully treated by massage and movement from the outset, are apt to
be followed by the formation of adhesions, resulting in stiffness of
the joint.

#Contusion# in this r