A treatise on orthopedic surgery . A. Complete fracture of the neck of the femur, illustrating the influence ofthe muscles in increasing the displacement. B. Complete fracture, after reduc-tion and fixation in the position of abduction, illustrating the security assuredby the direct contact of the trochanter with the side of the pelvis; also thetension on the capsule and the removal of the deforming influence of the muscles. CONGENITAL DISLOCATION OF HIP AND COXA VABA. 591 with the following modification. The patient lying in the posi-tion described with the sound limb held in abduction the di
A treatise on orthopedic surgery . A. Complete fracture of the neck of the femur, illustrating the influence ofthe muscles in increasing the displacement. B. Complete fracture, after reduc-tion and fixation in the position of abduction, illustrating the security assuredby the direct contact of the trochanter with the side of the pelvis; also thetension on the capsule and the removal of the deforming influence of the muscles. CONGENITAL DISLOCATION OF HIP AND COXA VABA. 591 with the following modification. The patient lying in the posi-tion described with the sound limb held in abduction the dis-abled member is first flexed to disengage folds of capsule thatmay have fallen between the fragments. It is then extendedand rotated to the normal attitude and under traction andcounter-traction the shortening is completely overcome, as demon-strated by measurement. The limb is then slowly abductedby the assistant while the surgeon supporting the joint pushesthe thigh upward from beneath to force the two fragments Fig. The long spica as applied for the treatment of fracture of the neck of the femurIn the adult at an angle of abduction of 45 degrees. against the anterior part of the capsule. When the limit ofabduction has been reached the capsule will be tense, thusdirecting the fragments toward one another, the trochanterwill be apposed to the side of the pelvis, thus preventing up-ward displacement and the muscles whose contraction favorsdeformity, will be completely relaxed. A plaster spica is thenapplied, as in the preceding instance. In the treatment ofelderly subjects it is well to raise the head of the bed from to lessen the danger of hypostatic congestion of the lungsand to increase the blood supply at the seat of injury. Repairmust tie slow and weight must not be borne for many months. 592 OPiTHOPEDIC SUBGEEY. lu the after-treatment the support of a modified hip splint () is desirable, and functional recovery will be hastened bvmassage and by apj
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
