§1616.
16.
Χειρὸς δὲ ἄρθρον ὀλισθάνει ἢ ἔσω, ἢ ἔξω, ἔσω δὲ τὰ πλεῖστα.
The wrist joint is dislocated either inward or outward, most often inward.
Σημεῖα δ᾿ εὔσημα· ἢν μὲν ἔσω, ξυγκάμπτειν ὅλως σφῶν τοὺς δακτύλους οὐ δύνανται· ἢν δ᾿ ἔξω, ἐκτείνειν.
The signs are clear: if inward, they cannot flex their fingers at all; if outward, they cannot extend them.
ἐμβολὴ δὲ, ὑπὲρ τραπέζης τοὺς δακτύλους ἔχων, τοὺς μὲν τείνειν, τοὺς δ᾿ ἀντιτείνειν, τὸ δὲ ἐξέχον ἢ θέναρι ἢ πτέρνῃ ἅμα ἀπωθέειν πρόσω καὶ κάτωθεν κατὰ τὸ ἕτερον ὀστέον, ὄγκον τε μαλθακὸν ὑποθεὶς, κἢν μὲν ἄνω, καταστρέψας τὴν χεῖρα, ἢν δὲ κάτω, ὑπτίην.
The reduction is: keeping the fingers over a table, some [assistants] make extension, and others counter-extension, while one pushes the protruding part forward with the palm or the heel of the hand, and from below against the other bone, having placed a soft pad under it; if [the projection is] upward, having turned the hand prone, and if downward, supine.
Ἴησις, ὀθονίοισιν.
Treatment is with bandages.
§1717.
17.
Ὅλη δὲ ἡ χεὶρ ὀλισθάνει ἢ ἔσω ἢ ἔξω, μάλιστα δὲ ἔσω, ἢ ἔνθα ἢ ἔνθα· ἔστι δ᾿ ὅτε ἡ ἐπίφυσις ἐκινήθη· ἔστι δ᾿ ὅτε τὸ ἕτερον τῶν ὀστέων διέστη.
The entire hand is dislocated either inward or outward, most of all inward, or this way or that way; sometimes the epiphysis is displaced, and sometimes one of the two bones is separated.
Τουτέοισι κατάτασις ἰσχυρὴ ποιητέη, καὶ τὸ μὲν ἐξέχον ἀπωθέειν, τὸ δ᾿ ἕτερον ἀντωθέειν, δύο εἴδεα ἅμα, καὶ ἐς τοὐπίσω καὶ ἐς τὸ πλάγιον, ἢ χερσὶν ἐπὶ τραπέζης, ἢ πτέρνῃ.
In these cases, powerful extension must be made, and one must push the protruding part back and push the other in the opposite direction, in two directions at once, both backward and to the side, either with the hands on a table, or with the heel.
Παλίγκοτα δὲ καὶ ἀσχήμονα, τῷ χρόνῳ δὲ κρατύνεται ἐς χρῆσιν.
These are troublesome and unsightly, but in time they become strong enough for use.
Ἴησις, ὀθονίοισι ξὺν τῇ χειρὶ καὶ τῷ πήχεϊ, καὶ νάρθηκας μέχρι δακτύλων τιθέναι· ἐν νάρθηξι δὲ τεθέντα ταῦτα πυκνότερον λύειν, ἢ τὰ κατήγματα, καὶ καταχύσει πλέονι χρῆσθαι.
Treatment: with bandages along with the hand and the forearm, and to apply splints as far as the fingers; when placed in splints, to loosen them more frequently than in cases of fractures, and to use more affusion.
§1818.
18.
Ἐκ γενεῆς δὲ, βραχυτέρη ἡ χεὶρ γίνεται, καὶ ἡ μινύθησις σαρκῶν μάλιστα τἀναντία, ἢ ὡς τὸ ἔκπτωμα· ηὐξημένῳ δὲ τὰ ὀστέα μένει.
If from birth, the hand becomes shorter, and the wasting of the flesh occurs mostly on the side opposite to the dislocation; but in those who have reached full growth, the bones remain as they are.
§1919.
19.
Δακτύλου δὲ ἄρθρον ὀλισθὸν μὲν, εὔσημον, οὐ δεῖ γράφειν.
A dislocated finger joint is obvious, so there is no need to write about it.
ἐμβολὴ δὲ αὐτοῦ ἥδε· κατατείναντα ἐς ἰθὺ, τὸ μὲν ἐξέχον ἀπωθέειν, τὸ δὲ ἐναντίον ἀντωθέειν.
Its reduction is as follows: having extended it in a straight line, to push back the protruding part, and to push the opposite part in the other direction.
Ἴησις δὲ ἡ προσήκουσα, τοῖσιν ὀθονίοισιν ἐπίδεσις.
The proper treatment is bandaging with small bandages.
Μὴ ἐμπεσὸν γὰρ ἐπιπωροῦται ἔξωθεν.
For if not reduced, a callus forms over it from the outside.
Ἐκ γενεῆς δὲ ἢ ἐν αὐξήσει ἐξαρθρήσαντα τὰ ὀστέα βραχύνεται κάτω τοῦ ὀλισθήματος· καὶ σάρκες μινύθουσι τἀναντία μάλιστα, ἢ ὡς τὸ ἔκπτωμα· ηὐξημένῳ δὲ τὰ ὀστέα μένει.
If dislocated from birth or during growth, the bones become shorter below the dislocation; and the flesh wastes away mostly on the side opposite to the dislocation; but in those who have reached full growth, the bones remain as they are.
§2020.
20.
Μηροῦ ἄρθρον ἐκπίπτει κατὰ τρόπους τέσσαρας· ἔσω πλεῖστα, ἔξω δεύτερον, τὰ δ᾿ ἄλλα ὁμοίως.
The hip joint is dislocated in four ways: most often inward, secondly outward, and the others in like manner.
Σημεῖα· κοινὸν μὲν τὸ ἕτερον σκέλος· ἴδιον δὲ τοῦ μὲν εἴσω· παρὰ τὸν περίνεον ψαύεται ἡ κεφαλὴ, ξυγκάμπτουσιν οὐχ ὁμοίως, δοκέει δὲ μακρότερον τὸ σκέλος, καὶ πουλὺ, ἢν μὴ ἐς μέσον ἀμφότερα ἄγων παρατείνῃς· καὶ γὰρ οὖν ἔξω ὁ ποὺς καὶ τὸ γόνυ ῥέπει.
Signs: a common sign is the other leg; and specific to the inward dislocation: the head is felt near the perineum, they do not flex the limb in the same way, and the leg appears longer, and indeed by a lot, unless you extend them while bringing both legs to the middle; and indeed the foot and the knee incline outwards.
Ἢν μὲν οὖν ἐκ γενεῆς ἢ ἐν αὐξήσει ἐκπέσῃ, βραχύτερος ὁ μηρὸς, ἧσσον δὲ κνήμη, κατὰ λόγον δὲ τἄλλα· μινύθουσι δὲ σάρκες, μάλιστα δὲ ἔξω.
So if it is dislocated from birth or during growth, the thigh bone becomes shorter, the lower leg less so, and the other parts in proportion; and the flesh wastes away, especially on the outside.
Οὗτοι κατοκνέουτιν ὀρθοῦσθαι, καὶ εἰλέονται ἐπὶ τὸ ὑγιές· ἢν δὲ ἀναγκάζωνται, σκίμπονι ἑνὶ ἢ δυσὶν ὁδοιπορέουσι, τὸ δὲ σκέλος αἴρουσιν· ὅσῳ γὰρ μεῖον, τόσῳ ῥᾷον.
These patients dread standing upright, and they lean on the healthy side; if forced, they walk with one or two crutches, and they lift the leg; for the shorter it is, the easier it is to lift.
Ἢν δ᾿ ηὐξημένοισι, τὰ μὲν ὀστέα μένει, αἱ δὲ σάρκες μινύθουσιν, ὡς προείρηται· ὁδοιπορέουσι δὲ περιστροφάδην ὡς βόες, ἐν δὲ τῷ κενεῶνι καμπύλοι, ἐπὶ τὸ ὑγιὲς ἐξίσχιοι ἐόντες· τῷ μὲν γὰρ ἀνάγκη ὑποβαίνειν, ὡς ὀχέῃ, τῷ δ᾿ ἀποβαίνειν (οὐ γὰρ δύναται ὀχέειν), ὥσπερ οἱ ἐν ποδὶ ἕλκος ἔχοντες.
But in those who have reached full growth, the bones remain as they are, but the flesh wastes away, as has been said before; and they walk with a circular swing like oxen, bent at the flank, and having the hip prominent on the healthy side; for it is necessary for the one [leg] to go under the body to support it, and for the other to go outward (since it cannot support the weight), just like those who have a sore on the foot.
Κατὰ δὲ τὸ ὑγιὲς, πλάγιον ξύλῳ τῷ σώματι ἀντικοντέουσι, τὸ δὲ σιναρὸν τῇ χειρὶ ὑπὲρ τοῦ γούνατος καταναγκάζουσιν, ὡς ὀχέειν ἐν τῇ μεταβάσει τὸ σῶμα.
On the healthy side, they prop themselves with a staff held obliquely to the body, and they press down on the injured leg with the hand above the knee, so that the body is supported during the transition of steps.
Ἰσχίων κάτωθεν, εἰ χρῆται, κάτωθεν ἧσσον μινύθει καὶ ὀστέα, μᾶλλον δὲ σάρκες.
Below the hips, if the limb is used, the bones waste away less below, but rather the flesh.