A treatise on orthopedic surgery . t walk, as in infancy, the attitude, of abduc-tion may persist, although the muscular spasm may be it would appear that locomotion has a distinct influenceon the character of the distortion. Adduction causes apparent or practical shortening; for inorder to bring the adducted limb to the middle line of the bodyand parallel to its fellow, the pelvis must be tilted upward onthe affected side and downward on the other, the lumbar spinebending with the convexity toward the lower side (Figs. 217and 220). If the level of the pelvis be restored, the addu
A treatise on orthopedic surgery . t walk, as in infancy, the attitude, of abduc-tion may persist, although the muscular spasm may be it would appear that locomotion has a distinct influenceon the character of the distortion. Adduction causes apparent or practical shortening; for inorder to bring the adducted limb to the middle line of the bodyand parallel to its fellow, the pelvis must be tilted upward onthe affected side and downward on the other, the lumbar spinebending with the convexity toward the lower side (Figs. 217and 220). If the level of the pelvis be restored, the adductedlimb will be crossed over its fellow and the deformity is madeevident (Fig. 216). As has been stated, the attitude of flexion, adduction, andinward rotation, if it appears early, is usually an indication 316 ORTHOPEDIC SUBGEEY. of acute disease and of corresponding intensity of muscularspasm. But in most instances it is associated with tlie laterand destructive stage of the disease, and it by no means indi- FiG. 216. Fig. Apparent shortening. The adduc-tion of the right thigh is made evidentby the involuntary crossing of thelegs when the anterior superior spinesare on the same plane. Apparent shortening. When the ad-ducted limb is placed in the line ofthe body, the pelvis is tilted upwardon the adducted side and downwardon the other. The patient has com-pensated for the apparent shorteningby flexing the knee on the sound does not appear in the photo-graph. cates that the preceding symptoms have been more than ordi-narily acute. In fact, it is the attitude characteristic of a so-called natural cure (Fig, 218) when mechanical treatmenthas not been employed. It more often acompanies the later TUBERCULOUS DISEASE OF THE HIP-JOINT. 317 course of the disease, because its causes are in great degreemechanical. This is illustrated by Koenigs statistics of 499 cases of hipdisease. In 267 cases the limb was abducted, and in 31 per cent, ofthese there was actual shorten
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