A treatise on orthopedic surgery . form, in which the entiresternum is depressed, is rare. It is practically always acongenital deformity, and it is not susceptible to direct treat-ment. Minor Deformities of the Chest.—As has been stated, distor-tions of the chest secondary to deformity of the spine are oftendiscovered before the original cause is suspected. And the im-portance of the various minor irregularities of the chest or inthe direction of the ribs when once discovered is often exag-gerated. They are usually the result of preceding increase of the capacity of the chest by
A treatise on orthopedic surgery . form, in which the entiresternum is depressed, is rare. It is practically always acongenital deformity, and it is not susceptible to direct treat-ment. Minor Deformities of the Chest.—As has been stated, distor-tions of the chest secondary to deformity of the spine are oftendiscovered before the original cause is suspected. And the im-portance of the various minor irregularities of the chest or inthe direction of the ribs when once discovered is often exag-gerated. They are usually the result of preceding increase of the capacity of the chest by appropriate exercisesaids in the correction of asymmetry. SCAPULAR CREPITUS. Creaking or grating sounds induced by certain movements ofthe scapula on the thorax sometimes appear without apparentcause or are developed by exercises during the treatment oflateral curvature. In some instances bony irregularities, bursas, DEFORMITIES OF THE SPINE. 237 and the like may be present. Twenty-two cases are reported by Kuttner,^ Fig. Pectus excuvatum. This patient has ocular torticollis also. ACQUIRED LUXATION OR SUBLUXATION OF THECLAVICLE. Partial displacement of the sternal end of the clavicle is notparticularly uncommon. In some instances it is caused byinjury; in others no cause can be assigned. Most often thereappears to be a laxity of the capsular ligament that permits adisplacement during certain movements of the arm. The dis-placement is readily reduced, but the weakness and insecuritymay cause discomfort and disability. Treatment.—In some instances the displacement may be pre-vented by the pressure of a pad and truss spring, attached behindto the corset or braces and passing over the shoulder close to the ^ Deutsch. mecl. Wochenschrift, June 23, 1904. 238 OETHOPEDIC SUBGEBT. neck. Such an appliance is especially useful if the displacementoccurs at certain times only, as in dressing the hair, playing onthe violin, etc. Cures are reported as the result of the injectionof
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