File:A treatise on orthopedic surgery (1903) (14741925786).jpg

Identifier: treatiseonorth00whit (find matches)
Title: A treatise on orthopedic surgery
Year: 1903 (1900s)
Authors: Whitman, Royal, 1857-
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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s are operated upon at onesitting, and are fixed in the typical attitude (Fig. 304). Walkingis, of course, difficult, but the child is usually able to stand, andafter several months it is often able to get about on its feet aftera fashion (Fig. 312). When the second bandage is applied the limbs are let downsomewhat, but the degree depends, of course, on the initialstability. The after-treatment is the same as for the singledislocation, except, of course, that the subsequent period ofawkwardness is much longer. Massage and exercises (Fig. 310)are far more important than in single dislocation, as the weakness COXGEXITAL DISLOCATION OF HIP AXD COXA VARA. 523 is greater. The primary position during sleep may be assuredby a cushion or roll placed between the thighs. Prognosis. The Lorenz operation is not without danger. Thedeath-rate attributed to anaesthesia is disproportionately large inthe cases reported, and in this the violence of the manipulationsmay be an important factor. Fig. 310.
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The after-treatment following the removal of the bandage in a case of bilateraldislocation, illustrating hyperextension of the thighs. In 450 operations reported by Lorenz, the following accidentsoccurred : Fracture of the neck of the femur in 11 cases. Fracture of the pelvis in 3 Peroneal paralysis in 3 Crural paralysis in 5 Sciatic paralysis in 3 In the last cases the paralysis persisted; in the others it wastemporary. In 1 case the femoral artery was ruptured, thepatient recovering without ill-effect. In 1 case gangrene of theextremity necessitated amputation at the hip-joint. It may be stated, however, that in the younger class ofthe operation, if conducted with reasonable regard to the resist-ance of the tissues and to the susceptibility of the patient, Ispractically free from danger. In cases treated at the proper age—that is, under sis yearsbilateral and under eight for unilateral cases—nearly 50 percent. 521 ORTHOPEDIC SURGERY. of the unilateral and 25 per cent. (50 per ce

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