. The principles and practice of modern surgery . 274 DISEASE OF THE HIP-JOINT. 69.* through the bone, or cutting out a wedge-shaped portion, and then employing frequent motion so as to pre-vent the consoUdation of a callus andestablish a false joint. This operationwas successfully performed by Dr. RheaBarton, of Philadelphia, on the hip, in1827, and on the knee in 1838. It wasalso successfully performed by Dr. Gib-son, of Philadelphia, in a case of completeanchylosis of the knee, with not a vestigeof ligament, cartilage, or synovial mem-brane remaining. Having laid bare thefront of the joint
. The principles and practice of modern surgery . 274 DISEASE OF THE HIP-JOINT. 69.* through the bone, or cutting out a wedge-shaped portion, and then employing frequent motion so as to pre-vent the consoUdation of a callus andestablish a false joint. This operationwas successfully performed by Dr. RheaBarton, of Philadelphia, on the hip, in1827, and on the knee in 1838. It wasalso successfully performed by Dr. Gib-son, of Philadelphia, in a case of completeanchylosis of the knee, with not a vestigeof ligament, cartilage, or synovial mem-brane remaining. Having laid bare thefront of the joint by a V incision abovethe patella, he sawed out a wedge-shapedportion of the bone, and gently bentthe rest so as not to endanger thepopliteal vessels.! But of course thisis so serious an operation, that it mustnot be undertaken SECTION VII, ■OF DISEASE OF THE HIP-JOINT. This joint is exceedingly liable to chronic disease, and there are certainpeculiarities in the symptoms which render it expedient to devote a sectionto it in particular. The usual forms of disease are the chronic ulcerationof cartilage in the adult, and scrofulous caries of the head of the femur inchildren. The symptoms and consequences of both are nearly the same. Symptoms.—The disease begins with slight occasional pain, and moreor less lameness in the gait. As it advances, the pain becomes very ex-cruciating in the cases of ulceration of cartilage, whilst in those of scrofu-lous caries it is comparatively trifling; but in both forms it is felt chieflyin the knee; and in the scrofulous caries, this pain in the knee may bethe only symptom complained of; nay, there may be even some swellingthere. The criterion, however, is, that if the surgeon moves the hip-joint,or if he jerks the femur upwards against the acetabulum, great pnin willbe fe
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