A treatise on orthopedic surgery . of the variety of muscles and othertissues that may have become involved, and because the bodiesof the vertebrae lying within the trunk, of which the distortionis always greater than of the spinous processes, can be onlyindirectly affected by voluntary or by passive movements. The cultivation of the muscular system, and particularly ofthose muscles whose action is opposed to the habitual deformity,as applied to the trunk, is difficult, because there are in nearlyall developed cases two curves, the one primary and the other 182 OBTHOPEDIC SUBGEBY. secondarj, i
A treatise on orthopedic surgery . of the variety of muscles and othertissues that may have become involved, and because the bodiesof the vertebrae lying within the trunk, of which the distortionis always greater than of the spinous processes, can be onlyindirectly affected by voluntary or by passive movements. The cultivation of the muscular system, and particularly ofthose muscles whose action is opposed to the habitual deformity,as applied to the trunk, is difficult, because there are in nearlyall developed cases two curves, the one primary and the other 182 OBTHOPEDIC SUBGEBY. secondarj, in direction directly opposed to one another. Theseopposing curves are supplied in great j)art by the same muscles,and it is difficult by voluntary effort to lessen the convexity ofone without at the same time increasing that of the other. The avoidance of predisposing attitudes and fatigue is espe-cially difficult because the restful sitting posture is that v^^hichinduces deformity. Thus, only in recumbency is the spine Fig. Adjustable school seat. (Miller and Stone.) entirely relieved from weight, and even at such times the de-formity may be favored by the habitual attitude of the patient. Finally the spine cannot be supported without at the sametime restraining its normal motion. Nor is any brace perfectlyefficient, for while it may prevent the lateral deviation it canexercise little direct action on the rotation of the spinal column. It is apparent then that it is not the difficulty of formulatingprinciples, but the difficulty of applying them that makes thetherapeutics of rotary lateral curvature of the spine perplex-ing. In practice one must recognize the limitations of all sys-tems of treatment as applied to this particular deformity, andselect and combine methods that may be most applicable to theparticular case under treatment. LATEEAL CUBVATUBE OF THE SPINE. 183 For example, in the treatment of rliacliitic scoliosis in a youngchild one cannot count upon the volun
Size: 1265px × 1975px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
