A treatise on orthopedic surgery . slight, as, for example,when it follows rheumatism orsome form of infectious arthri-tis. But in most instances theattitude is indicative of moreadvanced disease and of destruc-tive changes within the joint. Changes in the Contour of theHip.—The changes in contourare caused primarily by the at-titude of the limb. If, as isusual, it is flexed, abducted, androtated outward the buttock ap-pears somewhat flatter and bjroader_than its fellow. Thegluteofempral fold is lawar be-cause of the tilting dowiivvardof the pelvis and it is^^shallosierbecause of the flexion.
A treatise on orthopedic surgery . slight, as, for example,when it follows rheumatism orsome form of infectious arthri-tis. But in most instances theattitude is indicative of moreadvanced disease and of destruc-tive changes within the joint. Changes in the Contour of theHip.—The changes in contourare caused primarily by the at-titude of the limb. If, as isusual, it is flexed, abducted, androtated outward the buttock ap-pears somewhat flatter and bjroader_than its fellow. Thegluteofempral fold is lawar be-cause of the tilting dowiivvardof the pelvis and it is^^shallosierbecause of the flexion. If thethigh is adducted, the glutealfold is elevated and the anterior aspect, the in-guinofemoral fold is deepenedand lengthened by flexion andadduction while abduction makesit less noticeable. Hoffman hascalled attention to the fact thatthe genitals and the interglutealfold point toward the adductedand away from the abductedthigh. Adduction makes thetrochanter more prominent, andabduction makes it less Stage of apparent shortening. Theleft limb Is adducted 35°, making anapparent shortening measured fromthe umbilicus of more than twoinches. In order to reduce the ob-liquity of the pelvis, the adductedleg must be crossed over its fellow.(See Fig. 216.) The apparent short-ening is compensated by the flexionat the knee on the sound side. Thisis not made clear in the photograph. To these primary changes inthe appearances must be added the effect of atrophy or of infll-tration and swelling, due directly to the disease. A certainamount of swelling indicating effusion into the joint is often 320 OBTSOPEDIC SUBGEBY. apparent in the inguinofemoral region, and infiltration of thedeeper tissues is sometimes evident on palpation. In such casesthere is usually a certain sensitiveness to deep pressure behindor in front of the trochanter. Palpable abscess is unusual in theearly stage of the disease. —Atrophy is an important sign of joint disease. Itis o
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
