Annals of surgery . re the foot touches the knee of the oppositeside, rotation of the thigh outward takes place so as to crossthe extremity in tailor fashion (Ogston). Flexion of the limbincreases the deformity, as may be explained by the positionand shape of the acetabulum, its upper and posterior marginbeing most prominent. Thus it interferes with the prominent COXA VARA. 935 trochanter so that on pronounced flexion the adduction takesplace and the tissues are markedly distended by the projectinggreater trochanter; thus, owing to the prominence of the tro-chanter, the assumption of the sitti
Annals of surgery . re the foot touches the knee of the oppositeside, rotation of the thigh outward takes place so as to crossthe extremity in tailor fashion (Ogston). Flexion of the limbincreases the deformity, as may be explained by the positionand shape of the acetabulum, its upper and posterior marginbeing most prominent. Thus it interferes with the prominent COXA VARA. 935 trochanter so that on pronounced flexion the adduction takesplace and the tissues are markedly distended by the projectinggreater trochanter; thus, owing to the prominence of the tro-chanter, the assumption of the sitting position is often painful,or rather the change from the erect to the sitting position.(Whitman.^) 20. Thomass test is absent. The popliteal space of theaffected side comes in direct contact with the table. 21. Urine is normal. 22. Standing position in bilateral variety (Mannockscase) : When standing erect with limbs close together, the toesof the right foot merely touch the heel of the left foot at anacute Fig. 4.—Showing elevation, trochanter major in coxa vara. 23. Face: According to Keetley there is a characteristicalteration of the bones of the face, a sort of expansion and anappearance of thinness in the orbital and nasal regions. When all other means of diagnosis fail and we are stillin doubt, we turn to the X-ray. In the radiograph: I. We notice no inflammatory changes in or around thejoint—no fractures, no separation of the epiphysis, nothing,only an apparent difference from the normal in the angleformed by the shaft and the neck, this yielding is not onlyfrom above downward, but is also from side to side, and this 936 RICHARD J. BEHAN. fact, if all the other conditions are excluded, makes ourdiagnosis. Diagnosis.—This condition should be diagnosed from:I, Congenital dislocation of hip; 2, hip disease; 3, local dis-eases, as osteomalacia; 4, traumatic coxa vara (fracture) ; 5,acute infantile paralysis; 6, ostitis deformans of hip. The differentiated dia
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
