A treatise on the etiology, pathology, and treatment of congenital dislocations of the head of the femur (1850) (14590014809)

Identifier: treatiseonetiolo00carn (find matches)
Title: A treatise on the etiology, pathology, and treatment of congenital dislocations of the head of the femur
Year: 1850 (1850s)
Authors: Carnochan, J. M. (John Murray), 1817-1887
Subjects: Femur Head Dislocations
Publisher: New York, Wood
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons



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n at the joint, sometimes at-tended by an audible sound, as happens in traumaticdislocations; or, the head of the femur can only bebrought into its anatomical position and retained there,until the plastic power of the organism be aroused, andthe elemental parts of the joint be gradually and mutuallyadapted to each other. To prevent the re-escape of the head of the femurfrom the rudimental cotyloid cavity, a circumstance whichis apt to occur, two large concave plates, padded andmovable upon hinges, are fixed upon the side of theapparatus, as seen in Plate B, and which, by means ofscrews, may be so adjusted as to embrace firmly thehaunches, and thus retain the head of the femur in itsnew position. When it is necessary to remove the patient from thebed, a girdle, with perineal straps, and confining the hips,is substituted, to prevent the femur from slipping from theacetabulum. A short time after the reduction has been effected, pains,accompanied by heat and tumefaction, are manifested in
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THE ITMENT. the inguinal region, attended l>\ febrile symptoms, andsometimes bj dysurj and incontinence of urine, (f thsymptoms are excessive, 111»• \ are to be calmed bj amoderate extension of the affected limb, and b\ emollientapplications; but as these phlogistic evidences are indi-cative of the occurrence of the organo-plastic effort, uponwhich the remodelling, as it were, of the acetabulum,—aswell as the modifications of* the adjacent parts, necessanfor the maintenance of the head of the lemur in itsnew position,—are dependant, they are to be regarded,when not excessive, as favorable signs; and wheretoo feebly developed, they must be aroused by artificialmeans. When the acetabulum and the head of the femur areconsiderably changed, the process of this plastic effort ofreparation generally requires from five to six months,before the configuration of the head of the femur andthe capacity of the acetabulum become reciprocally fittedfor each other. In cases where the head of