Hip disease in childhood : with special reference to its treatment by excision . ransmission of the jar or shock of impact with the ground SYMPTOMS. 65 through the heel to the hip. More probably the flexionand functional shortening is the cause. To sum up. Taking the usual classification of thecourse of the disease into the three stages of Ford, theposition assumed successively by the limb will be—inthe first stage, flexion to a variable degree, with or withoutslight abduction, and possibly rotation outward ; in thesecond stage, flexion usually well marked, with abduc-tion usually, and rotatio
Hip disease in childhood : with special reference to its treatment by excision . ransmission of the jar or shock of impact with the ground SYMPTOMS. 65 through the heel to the hip. More probably the flexionand functional shortening is the cause. To sum up. Taking the usual classification of thecourse of the disease into the three stages of Ford, theposition assumed successively by the limb will be—inthe first stage, flexion to a variable degree, with or withoutslight abduction, and possibly rotation outward ; in thesecond stage, flexion usually well marked, with abduc-tion usually, and rotation outward, producing apparentlengthening {Figs. 38 and 39); sometimes, however, thereis adduction, and sometimes mere flexion, with no rotation,or with rotation inward ; in the third stage, there is alwaysflexion, and most commonly adduction and rotationinward {Fig. 40), with apparent or real shortening, butthere may be abduction and rotation outward. Thusposition, though a valuable, is not an absolute guide, andrequires to be checked by the other symptoms present. Fig. Shows one of the positions assumed in double hip disease. There is extreme lordosis,actual shortening from displacement, and some rotation. The way in which the rightleg overrides the left suggests a possible development of scissor-legged deformity(Lucas) later. 66 ON HIP DISEASE IN CHILDHOOD. Scissor-legged Deformity after Hip Disease.—Mr. Lucas,*Dr. Tyson of Folkestone, and others have recorded caseswhere, as a result of double hip disease, a peculiar cross-legged or scissor-legged deformity occurs ; both legs areadducted, the one in front of the other, and progressiontakes place entirely by movement at the knee joint. It iseasy to understand the condition by simply walking withthe knees crossed over one another. It occurs, accordingto Mr. Lucas, in cases where disease has occurred first inone joint, resulting in adduction, and then subsequently inthe other joint. Other deformities may result from the
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