. Un traité sur les fractures et luxations des articulations. ation de ce os. Cas CCCXVI.-Un monsieur est venu à ma maison, dont la première pha-lanx avait été jeté sur l'arrière de l'os métacarpien de lepouce par l'éclatement d'une arme à feu. Les muscles fléchisseurs, et l'ab-ductor, étaient beaucoup lacérée juste en dessous ; le extensorswere trapèze theos indemne. J'ai appliqué le ruban pour la première phalange, et l'extension,facilement réduit ; J'ai alors introduit les bords de la téguments de-gether par suture, et réalisé un cataplasme à appliquer, en raison de la grande contusion des pièces : et la reprise a été très

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. A treatise on dislocations and fractures of the joints. ation ofthis bone. Case CCCXVI.—A gentleman came to my house, whose first pha-lanx had been thrown upon the back of the metacarpal bone of thethumb by the bursting of a gun. The flexor muscles, and the ab-ductor, were much lacerated just below theos trapezium ; the extensorswere uninjured. I applied the tape to the first phalanx, and extending, easily reduced it; I then brought the edges of the integuments to-gether by suture, and directed a poultice to be applied, on account ofthe great contusion of the parts : and the recovery was very complete. DISLOCATION OF THE LAST PHALANX OF THE THUMB. If this be a simple dislocation the best mode of reducing it is, thatthe surgeon should grasp the back of the first phalanx with his fingers, apply his thumb upon the fore part of the dislocated phalanx, and thenbend it upon the first as much as he possibly can. In compound dislocations of this joint (of which I have given aplate), it is best to saw off the extremity of the second phalanx, taking. care not to injure the tendon which is torn through; for when thebone is removed, the ends of the tendon may be readily approximated, and adapted to each other. The extremity of the tendon should besmoothed by a knife, and the part be then bound up in lint, dipped inblood, and confined by a roller; and it should be kept quiet for a fort-night or three weeks, when passive motion may be begun. The three following cases which occured in the Editors practicewill illustrate the efficacy of the rules laid down. Case CCCXVIL—In June, 1833, a gentleman called at my houseto consult me, who, the evening before, had been thrown down from 448 DISLOCATION OF THE LAST PHALANX placing his foot upon a piece of orange-peel; he fell to the groundwith treat violence, and immediately upon the inferior part of hisright thumb, which forced the superior extremity of the last phalanxupon the dorsal surface of the second ; the extreme phalanx was per-

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