Lateral curvature of the spine and round shoulders . issey. ^Hiissey: Zeitsch. f. orth. Chir., viii, 2, 235. ^ Vulpius: Volkmanns Samml. klin. Vort., 276. Fig. 137.—On the Left is a DiagramShowing a Right Dorsal Left LxjmbarCurve. In the middle diagram the curve isshown straightened; on the right thecurve has been pushed over to the leftunchanged. 164 TREATMENT Technic of Application.—The patient should preferably be stretched once ortwice daily for two or three days preliminary to the correction, but this is notessential. Anesthesia is never necessary, as all endurable correction may beobtain
Lateral curvature of the spine and round shoulders . issey. ^Hiissey: Zeitsch. f. orth. Chir., viii, 2, 235. ^ Vulpius: Volkmanns Samml. klin. Vort., 276. Fig. 137.—On the Left is a DiagramShowing a Right Dorsal Left LxjmbarCurve. In the middle diagram the curve isshown straightened; on the right thecurve has been pushed over to the leftunchanged. 164 TREATMENT Technic of Application.—The patient should preferably be stretched once ortwice daily for two or three days preliminary to the correction, but this is notessential. Anesthesia is never necessary, as all endurable correction may beobtained without much pain. A seamless undervest is put on and the iliaccrests padded with heavy felt; a pad should also be placed over the the side straps heavy felt or cotton pads are required. The correction is pushed to the point of causing mild discomfort, and difl&cultyin breathing is a sign of too much correction. The amount to be obtained in anycase is better decided by the patients sensations than by any theoretical stand- r. Fig. 138.—Patient of Whom Radiograms were Taken before Treatment. (January,1906.)—{Am. Jour. Med. Assn.) ard. The danger lies on the side of obtaining too much rather than too littlecorrection, for the jacket will be much more uncomfortable when the erect posi-tion is assumed. After correction the patient should remain in a hospital under close obser-vation for at least twenty-four hours. Some shock is not infrequently experi-enced and in a case of the writers very serious collapse and cyanosis followedthe correction of a severe curve due to infantUe paralysis in a child of six. Wull-stein has recorded the occurrence of somewhat serious symptoms followingcorrection. Advantages and Disadvantages of the Prone Position.—The spinein this position is slack and easily displaced to the side and twisted, APPLICATION OF JACKETS 165 and the back is in view of the surgeon during the appHcation, enab-ling him to see just what correction is be
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