A treatise on orthopedic surgery . superior spines of the ilium. The Reduction of Deformity by the Thomas Method.—Preferablyin the treatment of children the double brace is applied, thesound limb being fixed in the extended position while the flexedlimb is supported by the other arm of the brace, bent to theangle of deformity. The patient is confined to the bed and, asthe muscular spasm relaxes under the influence of enforced rest,the brace is straightened slightly by wrenches from time to time, TUBEBCULOUS DISEASE OF THE HIP-JOINT. 363 at a point opposite the joint, to conform to the improved
A treatise on orthopedic surgery . superior spines of the ilium. The Reduction of Deformity by the Thomas Method.—Preferablyin the treatment of children the double brace is applied, thesound limb being fixed in the extended position while the flexedlimb is supported by the other arm of the brace, bent to theangle of deformity. The patient is confined to the bed and, asthe muscular spasm relaxes under the influence of enforced rest,the brace is straightened slightly by wrenches from time to time, TUBEBCULOUS DISEASE OF THE HIP-JOINT. 363 at a point opposite the joint, to conform to the improved posi-tion until symmetry is restored. In resistant cases this gradualrelaxation is hastened by straightening the brace somewhat atintervals, to which the attached limb must conform—a gradualforcible reduction of deformity. According to Ridlon andJones, the flexed limb is often forced to conform to the straightbrace by a temporary exaggeration of the lumbar lordosis whichlessens as the spasm subsides under treatment. Fig. Thomas splint applied with patten and crutches. The treatment is divided by Mr. Thomas into stages: 1. A preliminary stage of rest in bed for the reduction ofdeformity and to allow for subsidence of acute symptoms. 2. The patient is then allowed to go about on crutches wearingan iron patten at least four inches in height under the soundfoot (Fig. 249). 3. When all symptoms of disease have subsided and whenatrophy of the muscles is marked the brace may be removed atnight. 364 OETHOPEDIC SUEGEEY. 4. The brace is finallj discarded, but the patten aud crutchesare still used in walking. The records of Mr. Thomas show the average time of confine-ment to the bed to be twenty-two weeks, and the average dura-tion of treatment twenty-one months. It is stated by Ridlon^ that in actual practice these principleswere not carried out, for nearly all the children treated underThomas direction at the time his observations were made werewalking about without the high
Size: 1130px × 2212px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
