Lectures on orthopedic surgery . to deal. Si/mptoms.—Almost invariably the first symptomnoticed is a slight limp. This usually begins before-there has been any complaint of pain, and it re-mains until a cure hasbeen effected, and not in-frequently it persists tothe very end of life. Ina few cases there may beone or more intervals ofintermission during theearly months of the dis-ease. The limp is due tothe inability of the patientto fully extend the thighon the pelvis more than toany sensitiveness of thejoint to weight-bearing;although in untreatedcases, and in very manythat are subjected to tr
Lectures on orthopedic surgery . to deal. Si/mptoms.—Almost invariably the first symptomnoticed is a slight limp. This usually begins before-there has been any complaint of pain, and it re-mains until a cure hasbeen effected, and not in-frequently it persists tothe very end of life. Ina few cases there may beone or more intervals ofintermission during theearly months of the dis-ease. The limp is due tothe inability of the patientto fully extend the thighon the pelvis more than toany sensitiveness of thejoint to weight-bearing;although in untreatedcases, and in very manythat are subjected to treat-ment, there comes a timewhen walking is difiicultor impossible from thesensitiveness of the jointand its inability to sus-tain the weight of thebody. Nevertheless, the characteristic limp of hip-disease is not one of pain ; it is ra-tlier one of impairedfunction. As a rule, the patient very early in the disease be-comes restless in sleep, and may cry out without fullyawaking. The cry is peculiar, and consists in a sudden,.. Fig. 83. — Early stage of hip-disease^Flexion of right leg without notice-able lateral deformity. 124 sharp, frightened scream, occurring during the firsthours of sleep. These night-cries commonly precedeand almost invariably accompany a period of have been considered as characteristic of osteitis, though there can be no doubtof the presence of osteitis incertain cases in which nonight - cries are heard; it ismore probable that they areindicative of a rather rapiddevelopment of a tuberculousabscess under tension. Thesymptom is valuable in theearly stage of the disease onlyas corroborative of othersymptoms and as a hint tothe prognosis of abscess. Pain is usually complainedof at some time during thecourse of hip-disease, but thefact must not be lost sight ofthat it is rarely complainedof until long after limpinghas appeared. It disappearsmonths and often years be-fore the joint is cured; andpatients with nonsuppura-tive, and at times with su
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
