If a joint is dislocated, or a bone broken, don't grasp the limb at once and pull; but first consider the anatomy of the injured part. Rough and unskilled handling is likely to do more harm than good.
A dislocation means that the head of a bone has slipped out of its socket, probably tearing the ligaments, and has failed to slip back again as in a sprain. Some dislocations, particularly of the wrist or ankle, are hard to distinguish from fractures.
When you must operate on a comrade, go to work at once, before the muscles have become rigid and the joint badly swollen. Should much difficulty be experienced, do not persist in trying to get the joint into place, but surround it with flannel cloths wrung out in hot water, and support with soft pads, until a surgeon can be found.
After a dislocation has been reduced, the joint must be kept rigid with bandages or splints for a considerable time, as the ligaments are weak and a recurrence of the trouble is all too easy.
Three dislocations out of every four are in the shoulder, arm, or hand, and among these, dislocation of the shoulder is most frequent.
Pull straight out away from the hand. Generally the bone will slip into place. Dislocation of the thumb is more likely to be forward than backward. Press the thumb backward and at the same time try to lift the head of the bone into its socket. If you fail, after one or two trials, go for a surgeon.
Fracture is more common than dislocation of the wrist. If in doubt, treat as a fracture.
When there is only a bone out of joint, it may be replaced by pulling strongly upon the hand.
.Leave this dislocation tor a surgeon, if practicable. Otherwise, have the patient sit on a chair or log, and plant your foot against it. Place your knee against the front of his upper arm just above the bend of the elbow. Then, grasping the bone of the upper arm with your right hand, and the wrist with your left, forcibly bend the forearm, using your knee as a fulcrum. If the dislocation is forward, however, pull upon the forearm while the upper arm is fixed. Your thumb can assist in pressing the head of the bone in the desired direction. Put the arm in a sling (hand higher than elbow) and bandage it in place to prevent movement.
About one-half of all cases of dislocation are of the shoulder joint. Have the man lie down flat on his back, and seat yourself by his side, facing him. Remove your shoe, put your foot in his arm-pit, grasp the dislocated arm in both hands, push outward and upward with the heel, and at the same time pull the wrist downward and outward, then suddenly bring it against the patient's hip. When a snap is heard or felt, the joint is in place. Bandage the upper arm to the side, with a thick pad under the arm-pit, forearm carried across chest, and hand on opposite shoulder.
This dislocation must be reduced immediately. It looks serious, and alarms the patient, but in reality is very simple to reduce. Wrap both of your thumbs in several thicknesses of cloth, to protect them. Place them upon the patient's lower back teeth, and press forcibly downward and backward, while the fingers force the chin upward. As soon as the jaw starts into place, slip your thumbs off the teeth into the cheeks, to avoid being severely bitten. Put a jaw bandage on the patient.
To reduce this dislocation is a job for nobody but a good surgeon.
The patient lies down and bends his leg to a right angle at the knee. Then he, or an assistant, grasps his hands around the thigh and pulls backward, while you pull the foot steadily toward you. When reduced, support the joint with a right-angled splint made by nailing two pieces of board together in that position, one for the foot and the other for the lower leg.