Hip disease in childhood : with special reference to its treatment by excision . residual abscess, vide infra). Extension.—In i860, Mr. Barwell, by his experimentsby means of extension and driving wedges into the spacebetween the head of the femur and the acetabulum, demon-strated that no lengthening could possibly be producedby any such means. His experiments were, however,devised to disprove the occurrence of real lengtheningin the early stages of hip disease; they have an additionalvalue in their bearing upon the treatment of hip disease byextension. Dr. E. H. Bradford, of Cambridge,
Hip disease in childhood : with special reference to its treatment by excision . residual abscess, vide infra). Extension.—In i860, Mr. Barwell, by his experimentsby means of extension and driving wedges into the spacebetween the head of the femur and the acetabulum, demon-strated that no lengthening could possibly be producedby any such means. His experiments were, however,devised to disprove the occurrence of real lengtheningin the early stages of hip disease; they have an additionalvalue in their bearing upon the treatment of hip disease byextension. Dr. E. H. Bradford, of Cambridge, , made furtherexperiments by extension, and found that, though in anadult a weight of one hundred and fifty pounds producedno separation of the head of the femur from the acetabulum, TREATMENT. 87 yet in the foetus it did do so, a fact explicable by the soft-ness of the cotyloid cartilage and other factors of the jointat that age, and so in disease the softening produced byinflammation of the tissues no doubt does enable extensionto have an appreciable separating power. Fig. Bryants splint. I have had sliding pieces made to fill up the interruptions when required;this is seen in the figure. I have found that too great extension may be a causeof painful spasms, and it is well to bear this in mind thattoo little or too great extending force are alike cases where treatment without operation is carried out,as for instance where adhesions, the result of old inflam-mation, exist, or muscular contracture has taken place,the deformity may be remedied in many instances by theordinary extension apparatus by a weight, or by Bryantssplint. In other cases where simple extension is inefficient,or too tedious, it may be necessary to forcibly straightenthe limb under chloroform, and then fix it by splints in itsnew position. The advisability of forcible straightening isa somewhat disputed point, and is not in all cases free fromrisk, not only of laceration of important structu
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