A treatise on orthopedic surgery . the pos-terior and lateral muscles of the hip, and the child is encouragedto abduct and to extend the thigh, and bearing the weight on CONGENITAL DISLOCATION OF HIP AND COXA VABA. 557 the operated limb to sway the other limb laterally to the ex-treme limit. Passive movements are made, also, in the direc-tion of abduction and extension, the ability to reproduce thefirst or operation position during the early treatment being-considered essential. In certain instances the child for a timeshould sleep in this position, the attitude being assured by plac-ing the c
A treatise on orthopedic surgery . the pos-terior and lateral muscles of the hip, and the child is encouragedto abduct and to extend the thigh, and bearing the weight on CONGENITAL DISLOCATION OF HIP AND COXA VABA. 557 the operated limb to sway the other limb laterally to the ex-treme limit. Passive movements are made, also, in the direc-tion of abduction and extension, the ability to reproduce thefirst or operation position during the early treatment being-considered essential. In certain instances the child for a timeshould sleep in this position, the attitude being assured by plac-ing the child in a support of plaster corresponding to the pos-terior half of the original spica. Bilateral congenital dislocation is treated in the same man-ner as the unilateral. Both hips are operated upon at one sit-ting, and are fixed in the typical attitude (Fig. 371). Walk-ing is, of course, difiicult, but the child is usually able to stand,and after several months it is often able to get about on its feetafter a fashion. Fig. The after-treatment following the removal of the bandage in a ease of bilateraldislocation, illustrating hyperextension of the thighs. When the second bandage is applied the limbs are let downsomewhat, but the degree depends, of course, on the initial sta-bility. The after-treatment is the same as for the single dislo-cation, except, of course, that the subsequent period of awk-wardness is much longer. Massage and exercises (Fig. 368)are far more important than in single dislocation, as the weak-ness is greater. The primary position during sleep may beassured by a cushion roll or wooden frame as used by Lorenz. 558 OETEOPEDIC SUEGEEY. The Treatment of Congenital Dislocation in Infancy^—At tliejjresent time in contrast to former years one often lias the oppor-tiinitj to treat congenital dislocation in infancy and earlychildhood. The details of treatment do not differ essentiallyfrom those already described, except, of course, that reductionis easily
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