Hip disease in childhood : with special reference to its treatment by excision . on of important structures, but ofsetting up fresh inflammation in the joint, or what remainsof it. Mr. Howard Marsh* and, in 1836, Sir Benjamin Brodieadvised that the extension should be made in the axis ofthe limb, as it is at the time, and the direction should bealtered as the limb regains its normal position, I do notthink this is a matter of great * Brit. Med. Jour., July, 1,876. ?f If it is desired to carry out , probably Hodgens splint for fractureof the thigh would be the most efficie
Hip disease in childhood : with special reference to its treatment by excision . on of important structures, but ofsetting up fresh inflammation in the joint, or what remainsof it. Mr. Howard Marsh* and, in 1836, Sir Benjamin Brodieadvised that the extension should be made in the axis ofthe limb, as it is at the time, and the direction should bealtered as the limb regains its normal position, I do notthink this is a matter of great * Brit. Med. Jour., July, 1,876. ?f If it is desired to carry out , probably Hodgens splint for fractureof the thigh would be the most efficient apparatus. 88 ON HIP DISEASE IN CHILDHOOD. It is sometimes a matter of difficulty to remedy the mal-position of the limb in cases of fixation in combined flexionand adduction or abduction. Here, where possible, gradualreduction by a Bryants splint is the best treatment {Fig. 42);failing this, and it cannot be always used, a long splint on oneside, with a weight to the mal-placed side, should be tried{Fig. 43); and,failing this,careful straightening under chloro- Fig. Shows extension by a weight applied above the knee, with a long splint on the sound the simple plan of keeping the child from sitting up by means of the board runningbehind the shoulders and fastened to the side of the bed. The shoulders are fastenedto this board, and the arms are left free below the elbow. form. These methods are, I think, better than remedyingthe deformity by weights applied laterally. In more acutecases, where the deformity is mainly due to spasm, gradualextension is best, but by some means the limb must begot as quickly as possible into good position. Myotomy was at one time extensively practised, but isvery rarely necessary. Pancoast, however {Phil. , May, 1881), advocates tenotomy or myotomy in thesecond stage of the disease as a means of giving rest. Itis chiefly required in the class of cases to be next described. Where, as the result of natures cure of the dise
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