A treatise on orthopedic surgery . f Brackett,^ whocontrasted the atrophy of hip disease in two groups of patients,in one of which motion had been permitted, while in the otherfixation, as complete as possible, had been employed. In thefirst group the average of atrophy was but 1 per cent, of thevohime of the thigh and per cent, of that of the leg, as con-trasted with 23 per cent, and 17 per cent, in the second class. According to the investigations of Bum,^ simple fixation of asound limb induces more rapid atrophy than is caused by dis-ease of a joint when function has been permitted. No
A treatise on orthopedic surgery . f Brackett,^ whocontrasted the atrophy of hip disease in two groups of patients,in one of which motion had been permitted, while in the otherfixation, as complete as possible, had been employed. In thefirst group the average of atrophy was but 1 per cent, of thevohime of the thigh and per cent, of that of the leg, as con-trasted with 23 per cent, and 17 per cent, in the second class. According to the investigations of Bum,^ simple fixation of asound limb induces more rapid atrophy than is caused by dis-ease of a joint when function has been permitted. Nov can the ^ Transactions American Orthopedic Association, vol. Zeit. f. chir., December 9, 1905. TUBERCULOUS DISEASE OF THE EIP-JOINT. 321 atrophy induced by simple fixation be increased by the induc-tion of disease in the fixed joint.^ The atrophy caused by physiological disuse and diminishednutrition affects all the components of the limb. The skin be-comes thinner, the muscles lose in volume, the contractile sub- FiG. Early stage of disease of the left hip-joint (to the right in the picture) of thesynovial type, showing irregularity in the shape of the acetabulum. stance is replaced in part by fat and by fibrous tissue, and themedullary canals of the bones enlarge at the expense of thecortical substance. In childhood disuse often causes a retardation in growth ofthe entire extremity. This may be apparent in the foot when ^Wien. Med. Presse, 51, 322 OBTHOPEDIC SUBGEBY. it is placed bv the side of its fellow, while the diminishedgrowth in the length of the limb may be demonstrated by meas-urement. Brackett, in a series of cases, found this shorteningto be distributed as follows: average loss of the femur percent, and of the tibia per cent, of the normal length. Atrophy becomes less noticeable after function is resumed. Fig. 222.
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