Annual and analytical cyclopaedia of practical medicine . deepinto the bone, the skin over the tro-chanter having been injected with a dropor two of a 4-per-cent. solution of co-caine. In exceptional cases there maybe an effusion in the joint of so greatextent as to make aspiration advisable,but this is unusual. If the synovitis be-comes purulent the joint must be incisedand washed out with Thiersch or Labar-raque solution. The line of traction is this numner. And in such cases, wherefaithful trial of this method of reducingthe deformity fails to give results, thepatient should be anesthetized
Annual and analytical cyclopaedia of practical medicine . deepinto the bone, the skin over the tro-chanter having been injected with a dropor two of a 4-per-cent. solution of co-caine. In exceptional cases there maybe an effusion in the joint of so greatextent as to make aspiration advisable,but this is unusual. If the synovitis be-comes purulent the joint must be incisedand washed out with Thiersch or Labar-raque solution. The line of traction is this numner. And in such cases, wherefaithful trial of this method of reducingthe deformity fails to give results, thepatient should be anesthetized and thejoint forcibly straightened. If, at thistime, it is found that there is so muchcontraction of the rectus muscle or theadductors as to prevent reduction of thedeformity, except at the expense of vio-lently crowding the head of the femurinto the acetabulum, free section of thecontractured tissues should be made be-. Extension apparatus. to be changed little by little every fewdays, as the spasm of the muscles sub-sides, until the leg is gradually broughtparallel to its fellow and flat in bed,without disturbing the position of thetrunk and the sound leg. When the legscan be made parallel and rest on the bedwithout tilting the pelvis, a splint maybe applied. In some cases the diseasewill have advanced so far at the time offirst observation that adhesions will haveformed around the joint too strong topermit reduction of the deformity in fore reduction is attempted. The jointshould then be immobilized either witha splint or with a plaster-of-Paris dress-ing extending from the ankle to thethorax, while weight-and-pulley tractionis again resumed. If plaster of Paris isemployed, it should be reinforced at thegroin by a strip of iron to prevent crack-ling. Wlien the deformity has beenovercome and the joint is free from ac-tive inflammation, the patient may beallowed to rise when supplied with a suit-able
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