A treatise on orthopedic surgery . ere, forced from th^shortened toward the lengthened side (Tig. 90). If, for ex-ample, one attempts to place the ear as near the shoulder as ispossible there is necessarily an accompanying rotation of thechin in the opposite direction caused by the twisting of thebodies of the cervical vertebrse toward the convexity of the curve. In the simple accommodative lateral inclination of the bodyto one side or the other, the change in contour of the spine wouldbe more noticeable if it could be observed from the front ratherthan from the back, and as lateral curvature
A treatise on orthopedic surgery . ere, forced from th^shortened toward the lengthened side (Tig. 90). If, for ex-ample, one attempts to place the ear as near the shoulder as ispossible there is necessarily an accompanying rotation of thechin in the opposite direction caused by the twisting of thebodies of the cervical vertebrse toward the convexity of the curve. In the simple accommodative lateral inclination of the bodyto one side or the other, the change in contour of the spine wouldbe more noticeable if it could be observed from the front ratherthan from the back, and as lateral curvature is simply a per- 149 150 OETEOPEDIC SUEGEBY. sistent deviation of the spine, one of the so-called static deformi-ties which are directly induced or exaggerated by superincum-bent weight, it may be assumed that rotation of the vertebralbodies precedes the lateral distortion that first attracts rotation may not cause at once an appreciable degreeof external distortion, and, although marked lateral curvature Fig. Physiological rotation accompanying flexion and lateral inclination of the trunkin the normal subject. ^is necessarily combined with rotation, yet a slight degree ofdirect lateral inclination may exist unaccompanied by appre-ciable rotation. Rotation is usually understood to imply fixeddeformity, while lateral deviation may mean simply an habitualposture; but it is far simpler to consider the two as parts of onedistortion. The important distinction is between habitual de-formity, implying the habitual assumption of an improper atti-tude in which the accommodative changes in structure have notadvanced suiliciently to prevent voluntary or passive correction,and fixed deformity in which the changes in the bones and other LATERAL CUEVATUBE OF THE SPINE. 151 tissues have made cure difficult or impossible. The evidence offixed deformity is rotation that persists after the lateral devia-tion has been overcome. It persists because the early and im-portant ch
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