A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . ying an infant con-stantly on one side ; and occupying a lolling position during the greaterpart of the day will tend to lateral curvature in growing girls aboutthe menstrual epoch. Inequality in the length of the legs, due to dis-ease of the joints or to asymmetry in length, will equally lead tolateral curvature. Deformity of the chest from pleuritis, wearing an SPINAL CURVATURES. 779 artificial leg and ankylosis from hip disea
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . ying an infant con-stantly on one side ; and occupying a lolling position during the greaterpart of the day will tend to lateral curvature in growing girls aboutthe menstrual epoch. Inequality in the length of the legs, due to dis-ease of the joints or to asymmetry in length, will equally lead tolateral curvature. Deformity of the chest from pleuritis, wearing an SPINAL CURVATURES. 779 artificial leg and ankylosis from hip disease may be similar factors inspinal distortion. Rickets is a predisposing cause, as well as of osseousdeformities in other parts of the skeleton. Round shoulders, prominence of one hip, elevation of one shoulder,projection of the posterior border of one scapula and pain in the cor-responding shoulder and the back may be the first symptoms to attractattention. The pain may be scarcely noticeable during the day, butis felt at night or when lying down or sitting. It is often unim-portant. The winged scapula, as this deformity is termed, becomes Fig. 438. Fig. Photograph of case of left dorsal scoliosis. ( Lovett. ) Characteristic appearance of scoliosisin the stooping posture. (Lovett.; more marked; next a deviation of the dorsal spine in the lateral direc-tion is observed, and soon a secondary compensatory curve appears inthe lumbar region. Rubbing the skin over the spinous processes ofthe vertebra will cause red spots to appear over these bony promi-nences, so that the surgeon can readily determine the abseuce or ex-tent of the spinal curvature. The spinous processes, however, are inreality less displaced than the bodies of the vertebra? themselves,which have undergone lateral and rotary displacement. The spinal 780 ORTHOPEDIC SURGERY. column loses its flexibility and becomes somewhat stiff. The visceramay be injured and compressed by the deformed skeleton. If the de-formi
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