A treatise on orthopedic surgery . Forcible extension of the thigh. Third step in the operation. CONGENITAL DISLOCATION OF HIP AND COXA VAEA. 551 is forced downward behind the plane of the body, or the patientmay be turned upon the side, as in Eig. 361. After this pre-liminary stretching, traction is made upon the limb, and ifwith slight effort the trochanter can be drawn down to ISielatonsline reduction is attempted. Reduction.—The pelvis having been fixed as in the first posi-tion, the limb is slowly and forcibly abducted over a wedge ofwood suitably padded, the apex of which is placed betwe
A treatise on orthopedic surgery . Forcible extension of the thigh. Third step in the operation. CONGENITAL DISLOCATION OF HIP AND COXA VAEA. 551 is forced downward behind the plane of the body, or the patientmay be turned upon the side, as in Eig. 361. After this pre-liminary stretching, traction is made upon the limb, and ifwith slight effort the trochanter can be drawn down to ISielatonsline reduction is attempted. Reduction.—The pelvis having been fixed as in the first posi-tion, the limb is slowly and forcibly abducted over a wedge ofwood suitably padded, the apex of which is placed between thetrochanter and the pelvis (Fig. 362). As the limb is graduallyforced downward to and behind the plane of the body, the headof the femur is forced upward until it finally snaps over the pos-terior border of the acetabulum. Reduction is usually accom- FiG. Reposition. The thigti is forcibly abducted over the padded wedge. Fourthstep in the operation. The wedge is of hard wood of the following dimensions :length, 9% inches; height, 3% inches; base, 3 inches. panied by a distinct jar, and often by an audible thud. It isalso indicated by tension upon the posterior muscles of the thigh,which causes fixed flexion of the leg. The patient is then turnedupon the sound side and the pelvis, having been fixed by theassistant, the operator rotates the limb from side to side and atthe same time presses the trochanter downward and forwardwith the aim of forcing the head more completely within theacetabulum. The security of the reposition is then tests successively the stability or depth of the superiormargin of the acetabulum by reducing the abduction; of theposterior margin by lifting the thigh ventralward, and in asimilar manner the inferior border. Upon this examinationthe prognosis is made; if the stability allows an approximationt
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
