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Part 24

In dislocations forward the symptoms are the opposite: a vacuity behind, a protuberance before; of all motions they can least perform flexion, and extension best; the foot is straight, the limb is of the proper length at the heel; at its extremity the foot a little turned up; they are especially pained at first: of all these dislocations retention of urine occurs most frequently in this variety, because the bone is lodged among important nerves. The fore parts are stretched, do not grow, are diseased, and are obnoxious to premature decay; the back parts are wrinkled. In the case of adults, they walk erect, resting merely on the heel, and this they do decidedly if they can take great steps; but they drag it along; the wasting is least of all in this variety of dislocation, owing to their being able to use the limb, but the wasting is most behind. The whole limb being straighter than natural they stand in need of a staff on the affected side. When the dislocation is congenital, or has occurred during adolescence, if properly managed, the patient has the use of the limb as well as adults (otherwise?) have of it. But, if neglected, it is shortened [p. 289]and extended, for in such cases the joint is generally in a straight position. The diminution of the bones, and wasting of the fleshy parts, are analogous.

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