Lectures on orthopedic surgery . Fig. 88.—Disease of left hip. Marked flexion, adduction, and outward rotation. much inclined to believe that there is present in thesecases a shrinking of the muscular masses over andabove that due to disuse and to the constricting effectsof the dressings used. The muscular shrinking affectsthe thigh first, later the buttock, still later the calf, and 129 in some instances the whole limb. The symptom is soconstant that it may be regarded as of very great diag-nostic value. We have, however, seen one case inwhich there was no muscular shrinking, but the thigh. F
Lectures on orthopedic surgery . Fig. 88.—Disease of left hip. Marked flexion, adduction, and outward rotation. much inclined to believe that there is present in thesecases a shrinking of the muscular masses over andabove that due to disuse and to the constricting effectsof the dressings used. The muscular shrinking affectsthe thigh first, later the buttock, still later the calf, and 129 in some instances the whole limb. The symptom is soconstant that it may be regarded as of very great diag-nostic value. We have, however, seen one case inwhich there was no muscular shrinking, but the thigh. Fig. 89.—Same patient as shown in Fig. 88, with deformity reduced. ShowsThomas hip-splint with left wing of chest-band drawn higher than the right. was actually larger than the other throughout the entirecourse of the disease, which never presented any evi-dences of a suppurative process. Shortening may be either actual or practical, true or 130 false. True shortening is due either to arrested growth,to actual bone-destruction, or to partial or completedisplacement of the head of the femur from the ace-tabulum. None of these conditions are found early inthe disease, when a false lengthening is often present;but an accurate record should be kept, for in this waythe ultimate length of the limb can best be prognosti-cated. The true shortening is found by measuringfrom the anterior superior spine of the ilium to theinner malleolus on each side when the limbs are in likerelations to the median line of the body. Practical, orfalse, shortening is due to adduction or flexion, or fa
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
