A treatise on orthopedic surgery . and thethigh on the trunk, and w^ith theflexion adduction is usually com-bined. The arm is held against thethorax, the forearm is flexed uponthe arm in an attitude midway be-tween pronation and supination. Thehand is flexed upon the arm and in-clined toward the ulnar side and thefingers are clasped over the adductedthumb (Fig. 432). Disability.—The loss of power isnot absolute; in most instances thepatient is able to walk with an ex-aggerated limp, dragging the stiff-ened and distorted limb, whichserves as a prop. rather than as anactive support. So, also, th
A treatise on orthopedic surgery . and thethigh on the trunk, and w^ith theflexion adduction is usually com-bined. The arm is held against thethorax, the forearm is flexed uponthe arm in an attitude midway be-tween pronation and supination. Thehand is flexed upon the arm and in-clined toward the ulnar side and thefingers are clasped over the adductedthumb (Fig. 432). Disability.—The loss of power isnot absolute; in most instances thepatient is able to walk with an ex-aggerated limp, dragging the stiff-ened and distorted limb, whichserves as a prop. rather than as anactive support. So, also, the controlof the upper extremities is in partretained; the patient is able to ab-duct the arm, to partly extend theforearm, sometimes to extend the fingers and to abduct the thumb, but the power to dorsiflex thehand and at the same time to extend the fingers is not usuallyretained in a case of this character. Loss of Growth.—The growth of the patient as a whole isusually retarded to a certain extent by the lesion of the Acquired cerebral hemiplegia. 656 OBTHOPEDIC SURGEEY. There is in addition a certain degree of inequality in the growthof the two halves of the body. This inequality is more markedin the upper than in the lower extremity. Shortening to theextent of an inch in the lower extremity is not usually exceeded,but the growth of the arm and hand may be very markedlychecked. This disproportionate loss of growth in the upperover the lower extremity, although it may be explained in partby the situation of the the brain, depends more directlyupon the interference with function. The lower extremity israrely disabled to an extent that prevents its use in locomotion,consequently its nutrition is preserved; whereas, the same de-gree of paralysis of the arm utterly unfits it for its more difficultfunctions and it becomes a useless appendage. With the disuseof function there is a corresponding diminution of nutritionand a consequent atrophy and loss of growth.
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
