A treatise on orthopaedic surgery / by Royal Whitman.

  • Royal Whitman
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on orthopaedic surgery / by Royal Whitman. Source: Wellcome Collection.

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    vertebral bodies. When seated, particularly when riding in a carriage or street car, the patient often sits upon the edge of the seat, the shoulders only touching the back, while the hands rest instinctively on the seat, partially supporting the weight and steadying the spine. Stooping, a posture that increases the pressure on the diseased vertebral bodies and which necessitates muscular tension and strain in regaining the erect posi- tion, is particularly difficult and it is always avoided by the patient if the disease is at all acute. For example, when the child is asked to pick up an ob- ject from the floor, it either re- fuses or it squats on the heels or drops upon the knees (Fig. 14) instead of flexing the spine as in health. Young children, having seized the object on the floor, re- gain the erect attitude by push- ing the body up by the pressure of the hands on the thighs. If the child is placed upon the floor it will, if possible, seize the moth- er’s dress or will crawl to a chair or other object upon which the body may be drawn up by the arms, so that the discomfort caused by muscular contraction of the back muscles may be avoided. After the inspection and the observation of the motions and attitudes of the patient, the examination of the range of passive motion is made. The patient is placed at full length face downward on a table, and the range of extension and of lateral motion is tested by lifting the legs and swaying the body gently from side to side (Fig. 15). The spine is so flexible in childhood that rigidity even in the upper dorsal region may be demonstrated by this method, and in testing the lumbar region the thorax should be fixed by the hand of the examiner. While the patient remains in this attitude, one should test for psoas contraction. The pelvis is pressed firmly against the table with one hand, while the leg, held in the line of the body, is gently lifted by the other Lumbar disease. The manner of picking up an object.
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