This may be forwards, backwards, inwards and outwards, and are the results of severe force. The bones' ends are usually fractured at the same time. It is a very serious accident, and when it occurs to patients whose constitutions are bad amputation may often be necessary.

TREATMENT. -- Reduction is effected by bending at the knee, and while in that position, drawing the foot forwards.

In all cases of dislocations and fracture communicating with joints, the danger is anchylosis or stiffness of the joints. This is to be obviated by what is called passive motion, which is to be instituted in all cases, a few weeks after the accident. It is accomplished by taking hold of the limb and moving it in natural directions, as far as consistent, and repeated after suitable intervals. The patient is to be enjoined, also, when practicable, to exercise his limb at the wounded articulation. There are many other fractures and dislocations that I have not spoken of, for the reason that they are all so serious that the treatment should only be attempted by those having the proper anatomical knowledge and surgical skill.