File:American practice of surgery - a complete system of the science and art of surgery (1906) (14595746770).jpg

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
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Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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OF PLATE XXIV. The radiograph illustrates tuberculous disease in the left hip joint. There is considerable shorten-ing of the neck of the femur, as is evident when one compares the diseased side (Fig. 1) with the soundside (Fig. 2). The head of the bone and the acetabulum appear normal, but a tuberculous deposit i>seen in the upper part of the neck of the femur. The patient was fifteen years of age and had complainedof slight pain in the left hip for six months previous to observation; lameness manifested itself in anintermittent fashion; during the intervals he suffered no disability. Examination showed the char-acteristic muscle atrophy in the limb and limitation of movement. Under appropriate expectanttreatment the patient recovered. The x-ray picture was reproduced by Dr. S. Cummings, of Toronto, under whose care the patientwas treated and to whom the author is indebted for both the photographs and the history of the case.. AMERICAN PRACTICE OF SURGERY PLATE XXIV Fig. i Fig. 2
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RADIOGRAPHS ILLUSTRATING TUBERCULOUS DISEASE IN THEHIP-JOINT IN A PATIENT 15 YEARS OF AGE TUBERCULOUS DISEASE OF BONES AND JOINTS. 649 The fracture is usually of the green-stick variety, without separation of thefragments, but with change in the angle of the neck. Often the patient is ableto get about and use the limb soon after the injury, but he suffers pain anddiscomfort. When this condition exists, it is frequently mistaken for earlyand acute hip-joint disease. It will be found on inquiry that the disabilityfollowed immediately after the accident. Measurements will show a certain de-gree of shortening; the trochanter lying at a higher level than normal, andthe muscles on guard contracting to protect the injured joint. The x-ray heremay be utilized to establish the diagnosis. Coxa Vara.—In this condition there is sometimes an abnormal curvature ofthe femoral neck, producing a marked rotation outward, elevation of the tro-chanter major, and shortening of the limb. The neck of the

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