A treatise on orthopedic surgery . d. The gait is ex-tremely awkward, resembling somewhat that of knock-knees,for the limitation of abduction forces the patient to sway thebody from side to side in order that the knees may not interfere;and if the deformity is extreme the limbs may be crossed overone another, so that locomotion may be difficult. In the ordinaryform of bilateral coxa vara the femoral neck on each side isdisplaced backward as well as downward, and as the head of thefemur remains in the acetabulum the shaft is thrown forward,so that the trochanter is nearer the anterior superior
A treatise on orthopedic surgery . d. The gait is ex-tremely awkward, resembling somewhat that of knock-knees,for the limitation of abduction forces the patient to sway thebody from side to side in order that the knees may not interfere;and if the deformity is extreme the limbs may be crossed overone another, so that locomotion may be difficult. In the ordinaryform of bilateral coxa vara the femoral neck on each side isdisplaced backward as well as downward, and as the head of thefemur remains in the acetabulum the shaft is thrown forward,so that the trochanter is nearer the anterior superior spine thanis normal. This displacement of the support lessens the inclina-37 578 OBTHOPEDIC SUEGEEY. tion of the pelvis and consequently the normal lumbar lordosis. Bilateral coxa vara is not infrequently accompanied by other deformities, as, for example, knock-knee or flat-foot (Fig. 386), and it is usually an indirect result of former rhachitis while in unilateral coxa vara injury (fracture) is the most frequent cause. Fig. Cross-section of the pelvis and the deformed femur. A scheme to show theeffect of the deformity in limiting abduction of the limb. The dotted outlineshows the normal relation. Other Varieties of Coxa Vara,—Far less often the neck of thefemur may be depressed directly downward or even downwardand forward. In the latter instance the effect of the deformityupon the function of the joint is somewhat different from thatof the ordinary type. Abduction is limited, as in the commonform, but inward rotation replaces outward rotation, and ex-tension is limited in place of flexion. This type of deformityis almost always bilateral. It is accompanied, usually, by slightpermanent flexion of the thighs; thus the lumbar lordosis isexaggerated; whereas, in the ordinary form it is usuallylessened. This description applies to the ordinary types of the de-formity as it is seen in later childhood and in adolescence. It CONGENITAL DISLOCATION OF HIP AND COXA VARA. 579 u
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
