Reduction of a dislocation

Reduction is the act of returning a dislocated joint to its normal position. In the ancient world it was done by hand, often with traction: pulling the bones apart so the joint could be guided back.

The Greek Hippocratic text On the Articulations deals with dislocations, inflammation and the risk of recurrence. The Roman writer Celsus, in Book VIII of De Medicina, describes knee dislocation and its reduction, and sets out what to do afterwards.

As our research reads Celsus, the order matters:

1. Examine by sight and touch, comparing the injured joint with the healthy one.
2. Reduce it: traction separates the bones while the physician restores the joint with his hands.
3. Rest and protect the joint while it is inflamed. Celsus gives three days, sometimes five for stronger joints.
4. Apply hot water after the fifth day.
5. Begin rubbing only once the inflammation has settled.
6. Return to natural use of the limb when movement no longer hurts.

This is not modern physical therapy, and we do not describe it as such. Ancient physicians did not think in ligaments, nerves or blood vessels; they thought in terms of displacement, inflammation, rest and use.

• The Hands That Survived Rome. The composite legionary Marcus dislocates his knee in a training collision at Vindonissa around AD 35. His treatment follows the order above.