. The diseases of children : medical and surgical. hese cases the ace-tabulum is small, shallow, and may be filledwith fat or webbed over ; the head of thefemur may be nearly normal or much more or less perfect capsule may bepresent, and this may be thickened ; or,again, a sort of interosseous ligament mayexist : the ligamentum teres is atrophied,the muscles around the joint are affection may be unilateral or more oftenbilateral. The femur is usually freely movableand slides up and down upon the dorsum iliito an extent of sometimes two inches ormore (Plates IV., V.). The a
. The diseases of children : medical and surgical. hese cases the ace-tabulum is small, shallow, and may be filledwith fat or webbed over ; the head of thefemur may be nearly normal or much more or less perfect capsule may bepresent, and this may be thickened ; or,again, a sort of interosseous ligament mayexist : the ligamentum teres is atrophied,the muscles around the joint are affection may be unilateral or more oftenbilateral. The femur is usually freely movableand slides up and down upon the dorsum iliito an extent of sometimes two inches ormore (Plates IV., V.). The affected limb or limbs are usuallyimperfectly developed throughout. There isal\\ays a good deal of lameness in severe cases, though we have met withslight degrees of this deformity in which the joint was not very muchaltered. There are marked lordosis and a peculiar waddling way ofwalking which is very characteristic. Usually the displacement is upwardsand backwards, but it may be in almost any direction ; the limbs aresometimes adducted Fig. igo.—iCongenital Dislocationof both Hps. Not a severe > Dislocation of the htiinerus appears to be often associated with other conditions ofmalformation ; in a case shown us by our friend Mr. C. E. Richmond tliere were sub-spinous dislocation of the shoulder and dislocation of both hips. See Chapter on INJURIES. 2 See Hamiltons work on Frachcrcs and DislocatioTis. yC,2 Club-foot, Deformities of Limbs, &c. Besides the ungainliness of the walk, it is possible that the deformity ofthe pelvis may, as Adams suggested, be important from an obstetric point otview. There is little to be done for these cases, though it has been recom-mended that the affected limb should be supported and fixed in a state ofextension, and it is said that a certain amount of increased stability in thejoint may result.^ Section of the muscles surrounding the joint, and evenexcision, as well as scarification of the deeper tissues and hollowing out
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