Lectures on orthopedic surgery . nsidered as pointingto the development of abscess. Inspection of a case of hip-disease, stripped for examina-tion, reveals flexion of thethigh on the pelvis with orwithout accompanying abduc-tion or adduction. Most casespresent one or the other lateraldeformity, but the rule is notinvariable, and some cases runtheir course and go on to agreat degree of flexion withouteither abduction or adduction. Abduction when presentusually is found in the earlystage of the disease, and hasbeen looked upon as indicativeof efiusion into the joint, butof this we do not feel ce
Lectures on orthopedic surgery . nsidered as pointingto the development of abscess. Inspection of a case of hip-disease, stripped for examina-tion, reveals flexion of thethigh on the pelvis with orwithout accompanying abduc-tion or adduction. Most casespresent one or the other lateraldeformity, but the rule is notinvariable, and some cases runtheir course and go on to agreat degree of flexion withouteither abduction or adduction. Abduction when presentusually is found in the earlystage of the disease, and hasbeen looked upon as indicativeof efiusion into the joint, butof this we do not feel have observed abductionlate in the disease and in pa-tients where we have neverbeen able to make out fluctu-ation. The position of abduc-tion gives a false lengtheningto the limb, and is the causeof the obliteration of the but-tock-fold. Adduction usually appears when the flexion defor-mity has progressed so far as 25° to 40°. It gives afalse shortening to the limb and raises the buttock-fold^making prominent the Fig. 85.—Early stage of hip-dis-ease. Flexion and abductiondeformity s h o w iin g falselengthening. 126 Outward rotation or eversion of the limb usuallyaccompanies abduction, and inward rotation accom-panies adduction. Occasionally when there has beengreat destruction of the upper end of the femur, outwardrotation will be found associated with adduction. Thecause of the malpositions at the hip have not beenabsolutely determined ; but it would seem probable thatthe position of the tuberculous focus, together with the
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
