A treatise on orthopedic surgery . commodate the upwarddisplacement of the fe-mur. It is hypertrophied,especially where it coversthe upper part of the headof the bone, and it may bedrawn into shape like anhour-glass; the upper partcontains the head of thefemur; the anterior wallis drawn tightly across theacetabulum, forming atits upper border a narrowslit-like communication,through which the liga-mentum teres passes if itbe present (Fig. 349). The interior of the capsule is in partlined with synovial membrane, and it often contains moresynovial fluid than is found in the normal joint. The liga
A treatise on orthopedic surgery . commodate the upwarddisplacement of the fe-mur. It is hypertrophied,especially where it coversthe upper part of the headof the bone, and it may bedrawn into shape like anhour-glass; the upper partcontains the head of thefemur; the anterior wallis drawn tightly across theacetabulum, forming atits upper border a narrowslit-like communication,through which the liga-mentum teres passes if itbe present (Fig. 349). The interior of the capsule is in partlined with synovial membrane, and it often contains moresynovial fluid than is found in the normal joint. The ligamentum teres, although probably present at birth ina large proportion of the cases, becomes attenuated and ribbon-like with the increasing elongation of the capsule, and after theage of five years, or at the time when the open operation is per-formed, it is usually absent, and far more often in the bilateralthan in unilateral cases. According to Lorenz, in 52 cases be-tween two and a half and five years it was present in 17; in 48. Congenital dislocation of the hip, show-ing the original and the acquired acetabula.(Lorenz.) CONGENITAL DISLOCATION OF HIP AND COXA VABA. 539 cases beyond the age of five years it was present in but 4. Inrare instances it may be bypertrojDhied. In my own experiencetbe ligament is present in a very much larger proportion of thecases, although it is often so rudimentary that it might easilybe overlooked. A shallow secondary acetabulum, formed in part by the directpressure of the head of the bone through the adherent capsule,and in part the result of irritation of the periosteum, is usuallyfound upon the ilium (Fig. 350), but it is not often of sufficient Fig. 350.
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
