Notes on the dissection of a case of congenital dislocation of the head of the femur / by Francis J. Shepherd.

  • Francis Shepherd
Date:
[1880?]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on the dissection of a case of congenital dislocation of the head of the femur / by Francis J. Shepherd. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ;’.7o n slit; this slit embraces tlie neck of the femur, and it appears as if the head of the femur has worn away the capsule at this point by pressing it against the dorsum ilii. The nevj capsule is attached at its pelvic extremity around the socket which has been formed on the dorsum ilii by the wearing away of the bone, —at its femoral end it is attaclied internally to the slit in the old capsule through which the head of the femur protrudes, and externally is continuous with the inner surface of the gluteus minimus. It is ligamentous in structure, its inner surface is smooth, and a number of small villous processes are seen hang- ing from it. No synovial fluid can be seen. The ligamentum teres is entirely absent, no trace of it being seen either in the old acetabulum or in the head of the femur; it has probably been worn through and the two ends absorbed. Osseous Structures.—Femur. The whole bone is perceptibly smaller than that of the opposite side. The head is remarkably altered in appearance, it is of less size than normal, and where the ligamentum teres .should be attached it is flat and devoid of cartilage, as if it had been worn away or had lost its epiphysis; on the upper part of this flattened surface a shallow groove is seen, crescentic in form. The remaining part of the head is covered with cartilage. The compact bony tissue covering the head is remarkably thin, and on breaking it through the cancel- lated structure is found to be very soft. The neck of the bone is much shortened, and forms a right angle with the shaft; the upper part of the shaft is arched outwards; where the gluteus maximus was attached a rather prominent crest is seen. The lesser trochanter is absent, its place being occupied by a shallow groove. Pelvis.—The whole right half is smaller than the left. The wing of the right ilium is much thinner, more upright, more curled inwards, and altogether smaller than the left; the anterior inferior spine, is prominent, and in consequence the gi’oove below it in which lay the tendon of the psoas and iliacus is deeper. The rami of the pubis and ischium on the right side are flatter, thinner, and seem to spread out more than those of the opposite side, that is if a pei’iiendicular be dropped from the symphysis pubis, the angle formed by it with the lumi of the right side is much more obtuse than that formed by it with the
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