The surgical diseases of children . self. This pain is increased, or itspresence made evident, by gently pressing with thefingers in the middle of the base of Scarpas triangle,or between the ischial tuberosity and the great tro-chanter. Also by firmly pushing the great trochanterinwards, or by gently rotating the thigh outwards. The old method of diagnosis by striking the heel 4o8 The Surgical Diseases of Children. or the great trochanter is unscientific and untrust-worthy, as it does not help to differentiate betweendisease of the hip, of the sacro-iliac joint, or of thevertebrae. In each cas
The surgical diseases of children . self. This pain is increased, or itspresence made evident, by gently pressing with thefingers in the middle of the base of Scarpas triangle,or between the ischial tuberosity and the great tro-chanter. Also by firmly pushing the great trochanterinwards, or by gently rotating the thigh outwards. The old method of diagnosis by striking the heel 4o8 The Surgical Diseases of Children. or the great trochanter is unscientific and untrust-worthy, as it does not help to differentiate betweendisease of the hip, of the sacro-iliac joint, or of thevertebrae. In each case pain would follow the blow,and the child, being thus hurt or alarmed, will burstout crying and spoil the case for further attitude is characteristic. The intra-articularpressure being increased, the child cannot standevenly upon his two feet; were he to do so, the headof the femur would be thrust up into the already dis-tended capsule, and upon the swollen ligamentumteres. The thigh being already advanced from the. Fig. 70.—Limb brought down flat, but Loiu arched.* vertical line, he supports all his weight upon the limbof the sound side, the other knee being flexed, andthe toe gently touching the ground. When standing,he will be glad to obtain the support from a chair ortable. When the deformity is great, he may notbe inclined to attempt to stand or to walk, but willlie quietly and patiently day and night. The walk, too, is characteristic, for the thighbeing permanently advanced, and incompetent totransmit weight, the child limps uneasily, thoughadroitly, just touching the ground with the toe of theaffected side, and paddling himself along. This methodof progression soon tires him, and he gladly leaves hisplay to lie down. Shortening of limb in the early * Many of the woodcuts illustrative of disease of the hip andknee are modified from Thomass excellent work. chap, xxix.] Diagnosis of Hip Disease. 409 months of the disease does not actually exist; it ismere
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
