Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XXV. Of the DIVƲLSION of the BONES of the LEG.

I. THis kind of Dislocation is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Divulsio Ossium Cru∣ris; and in English, A Divulsion or parting asunder of the Bones of the Leg: That is, a separa∣ting or pulling asunder the Fi∣bula from the Tibia.

II. The Leg, strictly so called, is composed of two Bones, 1. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Tibia, Focile majus, the greater Bone, which is almost three-square, and by its smooth or flat side, and sharp edge be∣fore, makes that which we call the Shin. 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Fibula, Focile minus, the lesser Bone, which is as long as the former, but much slenderer, and is the outward Bone of the Leg.

III. These two Bones are slight∣ly conjoined to one another near each end; but in their middle they recede one from another; yet so, as they are tied toge∣ther by a strong Membranous Ligament, which comes be∣tween them.

IV. The Tibia at its upper end has a little head behind, which is below its upper and larger Ap∣pendix; this little head enters into the upper Appendix of the Fibula. At its lower end it has an Appendix, which is lesser than its upper. Appendix, which jets out with a notable Process to∣wards the inside of the Foot, making the Malleolus internus, or inner Ankle: it has two Cavi∣ties, one less, in its side, by which it receives the Fibula; another greater and lower, divi∣ded into two by a small Protu∣berance in the middle, and li∣ned with a Cartilage, which re∣ceives the convex head of the Talus that lies under it, as the said Protuberance is received by the shallow Sinus or Cavity in the convex head of the Talus.

V. The Fibula in its upper part has an Appendix, which reaches not so high as the Knee, nor is it joined to the Thigh-bone, but to the Tibia, as in the former Section is declared. At its lower end it has also an Appendix, which is received by the Sinus of the Ti∣bia, as aforesaid, and extend∣ing its Process to the side of the Talus, makes therewith, the Malleolus externus, or outward Ankle.

VI. The Causes. This Divul∣sion may come from those Causes, from which we said the Knee might be luxated, especially when walking in a slippery place, the Foot treads not firm∣ly, but is wrinched either in∣wardly or outwardly; as also from heavy Blows, Fall from an high place, &c.

VII. The Signs. A Tumor ap∣pears

in the Part to which the Fi∣bula is thrust forth; it is known by sight and touch; the motion also is hurt: and the Fibula may. be drawn from the Shin-bone three ways, viz. to the fore∣part, and on both sides.

VIII. The Prognostick. It is easily reduced, if it is recent: but if it is so old, (before re∣placing) that a Callus is bred, it can never be restored.

IX. The Cure. The sides of the Foot are to be pressed, to draw it back again; and it may be kept close with the Bandage which is ordered in the Fra∣ctures of the Tarsus.

X. Or you may easily bring it back again to its place, by forcing it to the contrary part with your Hands; after which, conveni∣ent Emplasters, Bolsters, Liga∣ture, and Placing, must be or∣dered, with quietness and rest for some Weeks, till the Liga∣ments are confirmed.