A treatise on orthopedic surgery . e shaft, while in adolescence the con-ditions may be reversed. The distortions at the knee are self-evident, but the neck ofthe femur is concealed from view; thus the diagnosis of coxavara may be somewhat difficult; and, in fact, it is only in com-paratively recent years that its symptoms have been ^ first described the deformity as it had been observedby him in children; but E. Mliller^ first called attention to theaffection as one of the deformities of adolescence, which, untilthat time, had been mistaken for hip disease. Pathology.—The te
A treatise on orthopedic surgery . e shaft, while in adolescence the con-ditions may be reversed. The distortions at the knee are self-evident, but the neck ofthe femur is concealed from view; thus the diagnosis of coxavara may be somewhat difficult; and, in fact, it is only in com-paratively recent years that its symptoms have been ^ first described the deformity as it had been observedby him in children; but E. Mliller^ first called attention to theaffection as one of the deformities of adolescence, which, untilthat time, had been mistaken for hip disease. Pathology.—The term coxa vara should not be applied to de-pression of the neck of the femur that may be secondary to de-structive disease, for example, to osteomyelitis, arthritis de-formans, osteomalacia, and the like, but it should be reservedfor cases of simple local deformity. In most instances the de- Gazetta degli Ospitale, 1881, Nos. 16, 17.^Beitrage zur klin. Chir., 1889, Bd. iv. CONGENITAL DISLOCATION OF HIP AND COXA VABA. 573 Fig. formity affects the neck as a whole (cervical coxa vara) ; inothers it is most marked at the epiphyseal junction (epiphysealcoxa vara), Epij)hyseal coxa vara is more often found in theadolescent class, and particularly in those cases in v^hich thesymptoms have been induced or aggravated by injury or the injury caused primarily a partial epiphyseal sepa-ration v^hich afterward slowlyincreased under the strain offunctional use; or suddenlyincreased a pre-existing dis-tortion of the weakened partis sometimes difficult to de-cide, but in most instancesthis type should be classifiedas fracture rather than as adevelopmental deformity. Anumber of specimens of coxavara have been examined,but no changes, other thansuch as might be caused bythe deformity itself, havebeen found. These are, inbrief, congestion and soften-ing of the bone, and evi-dences of irritation within noiwl femur at eight yeai^i^ age ;ang^^^^ formed by the neck with the shaft
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
