Orthopedic and reconstruction surgery : industrial and civilian / by Fred H. Albee.

  • Fred H. Albee
Date:
1919
Catalogue details

Licence: In copyright

Credit: Orthopedic and reconstruction surgery : industrial and civilian / by Fred H. Albee. Source: Wellcome Collection.

    1098/1152 (page 1090)
    Rationale. 'Flic ordinary position of the hi]) after any irritating condition ot the hip-joint is that of flexion,adduction, and internal rotation. This is the deformity we find in all untreated or imperfectly treated hip-joint affections. File posture produces lumbar lordosis and a very awkward limb. If the hip is fixed in the slightly flexed and abducted position, lumbar lordosis and probable consequent backache are avoided, and walking is rendered much easier. It the fool is slightly rotated outward, the ugly lift of the pelvis as the patient rises on the forefoot is prevented. The gait is more natural if the foot is rotated a little inward rather than straight forward.’ 1 # t Fit;. 803.—Comminuted fracture of external portion of head of tibia, with loss of sub¬ stance and marked knock-knee deformity. Although this was a simple fracture, the surgeon, who originally treated this case, removed all fragments; thus taking away the very ele¬ ments which would have restored the head of the tibia. Bone fragments in all similar cases should be religiously kept. Knee-joint. - Position. The knee-joint should alwavs be immobilized in a position of 10 to t5 degrees of flexion when there is danger of stiffness or ankylosis. Rationale. This position affords a more normal posture and greater ease in climbing stairs or silting. Sir. Robert Jones' objection to this flexed position, namely that owing to yielding of the fibrous or soft bony union there is danger of marked flexion deformity, is entirely obviated in the author’s practice by implantation of an inlay tibial graft which usually brings about immediate firm bony union. Ankle-joint. Position. The foot should always be fixed at a right angle with the leg, in a slight varus position.