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Image from page 319 of “A treatise on orthopedic surgery” (1910)
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Identifier: treatiseonorthop1910whit
Title: A treatise on orthopedic surgery
Year: 1910 (1910s)
Authors: Whitman, Royal, 1857-
Subjects: Orthopedics
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
Early stage of disease of the left hip-joint (to the right in the picture) of thesynovial type, showing irregularity in the shape of the acetabulum. stance is replaced in part by fat and by fibrous tissue, and themedullary canals of the bones enlarge at the expense of thecortical substance. In childhood disuse often causes a retardation in growth ofthe entire extremity. This may be apparent in the foot when ^Wien. Med. Presse, 51, 1906.21 322 OBTHOPEDIC SUBGEBY. it is placed bv the side of its fellow, while the diminishedgrowth in the length of the limb may be demonstrated by meas-urement. Brackett, in a series of cases, found this shorteningto be distributed as follows: average loss of the femur 6.6 percent, and of the tibia 5.4 per cent, of the normal length. Atrophy becomes less noticeable after function is resumed. Fig. 222.

Text Appearing After Image:
Advanced disease, showing wandering of tbe acetabulum and the obliquity ofthe pelvis due to adduction. Actual shortening one inch, apparent shorteningthree inches. the degree of final inequality depending upon the severity ofthe disease, the duration of the treatment, and upon the impair-ment of function. But even when free motion in the joint isretained, a certain degree of atrophy always persists and the lossin growth is never regained. If motion is completely lost the TUBERCULOUS DISEASE OF THE HIP-JOINT. 323 muscles about the joint lose in bulk in proportion to the disuseof their normal function; whereas the bones of the limb whichare still used to support the weight retain to a greater degreetheir normal size and length. Contrasted with this atrophythere is a relative hypertrophy of the sound limb, which isforced to assume more than its share of work. Actual Shoktenijstg.—^Actual shortening of the limb is aneffect rather than a diagnostic symptom of hip disease. Fig. 223. KALEV

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Licensed under a creative commons share alike. Use freely but give attribution to Bariatric Solutions (a Dallas weight loss surgery center) and link to