A treatise on orthopedic surgery . pica is then applied. This should be thick andfirm. The bandages are drawn snugly around the pelvis andthigh by a series of reverses and figure-of-eight turns, claspingthe iliac crests and thoroughly covering in the buttock. Thelower part is cut away, to permit motion at the knee-joint,especial care being taken to evert the edges and thus to prevent 554 ORTHOPEDIC SUBGESY. pressure. Tlie ends of the shirting are then drawn smoothlyover the bandage and are sewed to one another (Figs. 365 and366). The operation is usually followed by swelling and discolora-tion
A treatise on orthopedic surgery . pica is then applied. This should be thick andfirm. The bandages are drawn snugly around the pelvis andthigh by a series of reverses and figure-of-eight turns, claspingthe iliac crests and thoroughly covering in the buttock. Thelower part is cut away, to permit motion at the knee-joint,especial care being taken to evert the edges and thus to prevent 554 ORTHOPEDIC SUBGESY. pressure. Tlie ends of the shirting are then drawn smoothlyover the bandage and are sewed to one another (Figs. 365 and366). The operation is usually followed by swelling and discolora-tion in the adductor region and more or less pain, of a starting,spasmodic character, especially when the leg is moved. Thissoon passes away, usually during the first or second week, andthe child is then encouraged to stand. As it is only with ex-treme difficulty that the foot on the operated side can be broughtto the floor, a cork-soled shoe from one and a half to three inchesin height is usually worn to facilitate walking. Fig. A plaster bandage applied by Lorenz, illustrating the extreme thickness of thepelvic portion and discoloration of the adductor region. As has been stated, walking is encouraged on the theory thatweight bearing and the stimulation of functional activity willincrease the stability of the joint by deepening the acetabulum and accentuating its boundaries. In most instances the range of extension at the knee is for a time somewhat restricted. Thisrestriction is overcome by passive force and by the voluntaryeffort of the patient. The first bandage is retained from threeto six months or for a longer period, the skin being kept in goodcondition by daily vigorous rubbing with the band beneath thesupporting bandage. In addition the leg should be regularlymassaged; after a few weeks the bandage becomes loose aboutthe pelvis. This will permit rubbing of the buttocks. One isable also by palpation of the anterior region to ascertain whether CONGENITAL DISLOCATION
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