§2424.
24.
Οἷσι δὲ ἐς τοὔμπροσθεν, σημεῖα τἀναντία, ὄπισθεν λαπαρὸν, ἔμπροσθεν ἐξέχον, ἥκιστα ξυγκάμπτουσιν οὗτοι τὸ σκέλος, μάλιστα δὲ ἐκτείνουσιν·
In those with dislocation forward, the signs are the opposite: emptiness behind, prominence in front; they can flex the leg least of all, but can extend it most.
ὀρθὸς ποὺς, σκέλος ἴσον, πτέρνα· βραχεῖ ἄκρως ἀνέσταλται.
The foot is straight, the leg of equal length, and the heel is suspended at its very tip by a short distance.
Ἢ πονέουσι μάλιστα οὗτοι αὐτίκα, καὶ οὖρον ἴσχεται μάλιστα ἐν τούτοισι τοῖσιν ἐξαρθρήμασιν· ἐν γὰρ τόνοισιν ἔγκειται τοῖσιν ἐπικαίροισιν.
These suffer the most pain immediately, and urine is especially suppressed in these dislocations; for the pressure falls upon critical cords.
Τὰ ἔμπροσθεν κατατέταται, ἀναυξέα, νοσώδεα, ταχύγηρα· τὰ ὄπισθεν στολιδώδεις.
The parts in front are stretched, stunted, diseased, and prematurely aged; the parts behind are wrinkled.
Οἷσιν ηὐξημένοισιν, ὁδοιπορέουσιν ὀρθοὶ, πτέρνῃ μᾶλλον βαίνοντες· εἰ δὲ ἠδύναντο μέγα προβαίνειν, κἂν πάνυ· σύρουσι δέ·
In those who are fully grown, they walk erect, treading more upon the heel; and if they could take long steps, they would do so, but they drag the foot.
μινύθει δὲ ἥκιστα, τούτοισι δὲ ἡ χρῆσις αἰτία, μάλιστα δὲ ὄπισθεν· διὰ παντὸς τοῦ σκέλεος ὀρθότεροι τοῦ μετρίου, ξύλου δέονται κατὰ τὸ σιναρόν.
Wasting is least of all in these cases, the cause being the use of the limb, especially at the back; throughout the entire leg they are straighter than normal, and they need a staff on the injured side.
Οἷσι δὲ ἐκ γενεῆς ἢ αὐξανομένοισι, χρηστῶς μὲν ἐπιμεληθεῖσιν ἡ χρῆσις, ὥσπερ τοῖσιν ηὐξημένοισιν· ἀμεληθεῖσι δὲ, βραχὺ, ἐκτεταμένον· πωροῦται γὰρ τούτοισι μάλιστα ἐς ἰθὺ τὰ ἄρθρα.
In those with congenital dislocation or during growth, if properly cared for, the use is like that in adults; but if neglected, the limb remains short and extended, for in these cases the joints especially become ankylosed in a straight position.
Αἱ δὲ τῶν ὀστέων μειώσιες καὶ αἱ τῶν σαρκῶν μινυθήσιες, κατὰ λόγον.
The reductions of the bones and the wasting of the flesh are proportional.
§2525.
25.
Μηροῦ δὲ κατάτασις μὲν ἰσχυρή· καὶ ἡ διόρθωσις κοινὴ, ἢ χερσὶν, ἢ σανίδι, ἢ μοχλῷ, τὰ μὲν ἔσω στρογγύλῳ, τὰ δὲ ἔξω πλατεῖ, μάλιστα δὲ τὰ ἔξω.
For the thigh, extension must be powerful; and the correction is common, either by hands, or by a board, or by a lever—using a round one for inward dislocations, and a flat one for outward, especially for the outward.
Καὶ τὰ μὲν ἔσω, ἀσκοῖσιν ἀκεσάμενον, ἐς τὸ ὑπόξηρον τοῦ μηροῦ, κατατάσιος δὲ καὶ ξυνδέσιος σκελέων· κρεμάσαι διαλείποντα σμικρὸν τοὺς πόδας, ἔπειτα πλέξαντα ἐκκρεμασθῆναί τινα, ἐν τῆ διορθώσει ἀμφότερα ἅμα ποιεῦντα.
And for inward dislocations, having treated it with inflated wineskins in the fork of the thigh, and with extension and binding together of the legs; suspend the feet a little off the ground, and then someone, intertwining his legs, should hang from them, performing both actions at the same time during the correction.
Καὶ τῷ ἔμπροσθεν τοῦτο ἱκανὸν καὶ τοῖσιν ἑτέροισιν, ἥκιστα δὲ τῷ ἔξω.
And this method is sufficient for the forward dislocation and for the others, but least of all for the outward.
Ἡ τοῦ ξύλου ὑπόστασις, ὥσπερ ὤμῳ ὑπὸ τὴν χεῖρα, οἷς ἔσω· τοῖσι γὰρ ἄλλοισιν ἧσσον.
The insertion of the wooden bar under the perineum, like that under the armpit for the shoulder, is for those with inward dislocation; for it is less used for the others.
Καταναγκάσεις δὲ μετὰ διατάσιος, μάλιστα τῶν ἔμπροσθεν ἢ ὄπισθεν, ἢ ποδὶ ἢ χειρὶ ἐφίζεσθαι ἢ σανίδι.
Forced pressure combined with extension, especially for those forward or backward, is done by pressing down with the foot or hand, or by riding upon them with a board.
§2626.
26.
Γόνυ δὲ εὐηθέστερον ἀγκῶνος, διὰ τὴν εὐσταλίην καὶ εὀφυΐην· διὸ καὶ ἐκπίπτει καὶ ἐμπίπτει ῥᾷον.
The knee is more manageable than the elbow, because of its compactness and good structure; wherefore it both dislocates and reduces more easily.
Ἐκπίπτει δὲ πλειστάκις ἔσω, ἀτὰρ καὶ ἔξω, καὶ ὄπισθεν.
It dislocates most frequently inward, but also outward and backward.
ἐμβολαὶ δὲ, ἢ ἐκ τοῦ ξυγκεκάμφθαι, ἢ ἐκλακτίσαι ὀξέως, ἢ ξυνελίξας ταινίης ὄγκον, ἐν ἰγνύῃ θεὶς, ἀμφὶ τοῦτον ἐξαίφνης ἐς ὄκλασιν ἀφεῖναι τὸ σῶμα, μάλιστα ἐν τῇ τῶν ὄπισθεν·
Reductions are performed either by flexion, or by a sudden kick, or by rolling up a mass of bandage, placing it in the ham, and suddenly letting the body sink into a squatting position around this; this is done especially in backward dislocations.
δύναται δὲ καὶ κατατεινόμενα μετρίως, ὥσπερ ἀγκὼν, ἐμπίπτειν τὰ ὄπισθεν.
Backward dislocations can also be reduced by moderate extension, just like the elbow.
Τὰ δὲ ἔνθα, ἢ ἔνθα, ἐκ τοῦ ξυγκεκάμφθαι, ἢ ἐκλακτίσαι, [ἢ] ἐν καταστάσει, μάλιστα δὲ αὐτὴ τὸ ὄπισθεν· ἀτὰρ καὶ ἐκ κατατάσιος μετρίης.
Lateral dislocations (to this side or that) are reduced by flexion, or by kicking, or in a state of rest; but backward dislocation is especially reduced by the self-squatting method, as well as by moderate extension.
Ἡ διόρθωσις ἅπασι κοινή.
The correction is common to all.
Ἢν δὲ μὴ ἐμπέσῃ, τοῖσι μὲν ὄπισθεν ξυγκάμπτειν οὐ δύνανται, ἀτὰρ οὐδὲ τοῖσιν ἄλλοισι πάνυ τι· μινύθει δὲ μηροῦ καὶ κνήμης τὸ ἔμπροσθεν.
If not reduced, those with backward dislocation cannot flex the joint, nor indeed can those with the other dislocations do so to any great extent; and the front part of the thigh and leg wastes away.
Ἢν δὲ ἐς τὸ ἔσω, βλαισότεροι, μινύθει δὲ τὰ ἔξω.
If it is dislocated inward, they become knock-kneed, and the outer parts waste.
Ἢν δὲ ἐς τὰ ἔξω, γαυσότεροι, χωλοὶ δὲ ἧσσον, κατὰ γὰρ τὸ παχύτερον ὀστέον ὀχέει, μινύθει δὲ τὰ ἔσω.
If outward, they become bow-legged, but are less lame, for they bear weight upon the thicker bone; and the inner parts waste.
Ἐκ γενεῆς δὲ ἢ ἐν αὐξήσει, κατὰ λόγον τὸν πρόσθεν.
If from birth or during growth, it follows the proportion described before.
§2727.
27.
Τὰ δὲ κατὰ τὰ σφυρὰ κατατάσιος ἰσχυρῆς δεῖται, ἢ τῇσι χερσὶν ἢ ἄλλοισι τοιούτοισι, κατορθώσιος δὲ ἅμα ἀμφότερα ποιεύσης·
Dislocation at the ankles requires powerful extension, either by the hands or by other such means, and a correction performed both at the same time.
κοινὸν δὲ πᾶσιν.
This is common to all.
§2828.
28.
Τὰ δὲ ἐν ποδὶ, ὡς τὰ ἐν χειρὶ, ὑγιῆ.
Dislocations in the foot, like those in the hand, are easily cured.
§2929.
29.
Τὰ δὲ ἐν τῇ κνήμῃ συγκοινωνέοντα καὶ μὴ ἐμπεσόντα, ἐκ γενεῆς καὶ ἐν αὐξήσει ἐξαρθρήσαντα, ταῦτα ἃ καὶ ἐν χειρί.
Dislocations in the leg bones that are associated with each other and not reduced, or those dislocated from birth or during growth, have the same consequences as those in the hand.