Lectures on orthopedic surgery . Fig. 86.—Disease of the right hip. Marked flexion and adduction deformity. attitude assumed by the patient, determines the mal-position. The patient assumes the attitude of greatestcomfort, whether lying, sitting, or standing, and thisstrongly influences the deformity in the early stages ofthe affection. Later the malposition is determined bythe unbalanced force existing between the opposinggroups of muscles in their effort to immobilize the joint. 127 or between the muscular groups on the one hand and themechanical device employed in the treatment of thediseas
Lectures on orthopedic surgery . Fig. 86.—Disease of the right hip. Marked flexion and adduction deformity. attitude assumed by the patient, determines the mal-position. The patient assumes the attitude of greatestcomfort, whether lying, sitting, or standing, and thisstrongly influences the deformity in the early stages ofthe affection. Later the malposition is determined bythe unbalanced force existing between the opposinggroups of muscles in their effort to immobilize the joint. 127 or between the muscular groups on the one hand and themechanical device employed in the treatment of thedisease on the other hand. Muscular shrinking, generally believed to be due toreflex influence, comes on early, is very constant, andmay be regarded as a very valuable symptom. It hasbeen claimed bv careful observers that this muscular. Fig. 87.—Same patient as shown in Fig. 86, with flexion and adduction-deform-ity reduced. Also shows scar from hip-abscess ; also the Thomas hip-splintapplied to the right leg and the high patten on the left shoe. atrophy is due solely to disuse, inasmuch as it bearsno constant relation to any other factor involved; butwe have observed a patient who had limped for only 2weeks, who had suffered no pain, and had not ceasedfrom his usual avocations, whose aflected thigh meas-ured one inch less in circumference than the oppositethigh, a difference which went on increasing at a less, 128 but at an unusually rapid, rate during the succeedingfortnight before the application of apparatus. The factthat we do not know the relative sizes of the thighsbefore the limping commenced, renders the case of napositive value in controversial argument, but we are-
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
