A treatise on orthopedic surgery . bulum by reducing the abduction; of theposterior margin by lifting the thigh ventralward, and in asimilar manner the inferior border. Upon this examinationthe prognosis is made; if the stability allows an approximationto the normal position before displacement occurs the prognosisis good. If, on the other hand, the margins of the acetabulumare so ill-formed that elisplacement occurs very easily the prog-nosis is bad. 552 OETHOPEDIC SrSGESY. The operation is varied somewliat in certain instances. Ifafter the stretching the trochanter still remains above Xelato
A treatise on orthopedic surgery . bulum by reducing the abduction; of theposterior margin by lifting the thigh ventralward, and in asimilar manner the inferior border. Upon this examinationthe prognosis is made; if the stability allows an approximationto the normal position before displacement occurs the prognosisis good. If, on the other hand, the margins of the acetabulumare so ill-formed that elisplacement occurs very easily the prog-nosis is bad. 552 OETHOPEDIC SrSGESY. The operation is varied somewliat in certain instances. Ifafter the stretching the trochanter still remains above Xelatonsline, one attempts to overcome the remaining resistance bydirect traction in the line of the body. Counter-resistance isfurnished by a folded sheet passed between the thighs about theperineum, the two ends of which are tied about a corner of thetable. Traction on the limb is made by one or two assistantswhile the operator supports the pelvis and presses downwardand inward upon the trochanter. Occasionally reposition is Fig. Reposition in young subjects, the thumb being used as the fulcrum to Ieduce the left hip. effected during this manoeuvre—that is. the head is drawn overthe superior instead of the posterior border of the acetabulum. Preliminary Traction,^—In the treatment of older patients orof more resistant cases preliminary traction in bed is traction must be considerable, and heavy weights, if pos-sible up to forty pounds or more, should be employed for two ormore weeks. This is of great advantage. Reduction in Two Sittings.—If the reduction is more thanusually difficult, requiring more force than is deemed safe, thelimb should be fixed in a plaster spica in the attitude of abduc-tion, the actual reposition being deferred for one or more the second operation the reduction can be easily accomplishedin most instances. CONGENITAL DISLOCATION OF HIP AND COXA VARA. 553 Reduction in Young Subjects.—In younger subjects the wedgeis not nece
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