The Deformities of the Human Body (Paperback)

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1871 edition. Excerpt: ...and are placed nearer to the crests of the ilia than is natural; and the heads of the thigh-bones are to be seen projecting on the ilia, beneath the glutei (Fig. 53). The muscles of the dislocated limb remain small, from insufficient use; but children who are Fig. 53. thus affected are tolerably active, and can move about rapidly and without pain. Their motion, however, is very peculiar: it is, when both bones are dislocated, a rolling motion of the trunk, with more or less apparent insecurity or lameness. When the head of one femur is alone dislocated, the limb is shortened, so that the heel does not rest on the ground, and there is considerable weakness and yielding of the limb in walking; but the obliquity of the pelvis is less than when both bones are dislocated. In the child the lumbar curve, which in the erect position is so considerable, is effaced in the recumbent position; and in this position the head of the bone may be drawn down upon the acetabulum, and the length of the limb may be restored. Pathological Anatomy.--At birth the acetabulum is, I believe, never altered (in the cases of which I am now speaking--namely, those of dislocation upwards and outwards, where there is no other abnormality present), in shape or dimensions, and the head of the femur retains its normal appearance. Changes, however, subsequently take place, both in the cotyloid cavity and in the head of the bone, for the cartilage wastes and the cavity becomes partly filled up with cellulo-osseous material, while the head of the bone becomes at length somewhat irregular in shape, and its cartilage is thinned. The capsular ligament retains its integrity for some years: it becomes elongated; and as the head of the bone at length escapes through its capsule, the...