On the nature and treatment of the deformities of the human frame : being a course of lectures delivered at the Royal Orthopaedic Hospital in 1843 ; with numerous notes and additions to the present time / by W.J. Little.

  • William Little
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: On the nature and treatment of the deformities of the human frame : being a course of lectures delivered at the Royal Orthopaedic Hospital in 1843 ; with numerous notes and additions to the present time / by W.J. Little. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    Head said to be less heavy, although when recumbent is unable to raise it. The effects of structural shortening are more striking in children than in adults. In both, wasting results from sation of pins and needles; at one period the feet and legs could be pinched without his being aware of it. Sensation is now perfect. Contraction behind the heels appeared to commence at age of six, and has gradually increased to the present pe- riod. The shoulders appeared loose, and upper arm very small, so that a stranger would fear to grasp him by the arms. Both of these children lie supine the greater part of the day, occasionally sitting in an arm-chair suitably contrived for supporting the weak trunk. Both, when raised into a standing position, are so generally paralysed as to be incapable of supporting themselves. The vertebral column in both collapses and curves when unsupported, diminishing the length of the trunk, in the elder child to the extent of six inches. Constant slight curva- ture of lower dorsal and lumbar vertebra: to left side. He can remain a few minutes unsup- ported sitting on the edge of a chair, in which position he appears more upright than when seated farther back on the chair; the head is held upright, but when he is recumbent he uses much labour to raise it from the couch. Atrophy generally of both shoulders and upper arms exists, except that the deltoids, two inches below their origins, are larger in proportion to the re- mainder of the shoulders and upper arms; these muscles, however, do not possess any voluntary power. Slight contracture of both elbows, and slight contraction of pro- nators of both arms. He can raise the right arm only as high as the epigastrium ; the left is weaker, and can only be brought to the chest by a jerking movement, in doing which assistance is derived from some of the muscles of the trunk. He possesses very slight power in shoulders or elbows • more in wrist and fingers. He can reach his mouth and feed himself by resting the elbows on table. He can touch his head by alternately helping each hand with the other. The muscles of the calf are at present ST. ihose 0/0 eam,J °y °f«™ «ge, he possesses power of volition in them • s .ght volition also apparent in anterior bial, long and short extensor muscles of the toes, although these muscles are over come by the contracture of the calf. Ia unable entirely to close knees, although by Z Tve 8mainward rotati°«s of £ ct T^Cana!rS,ringthem con- tact. lhepllpi]sarelarge;s.ghtgood Afew , ^'^^^^^^^write^peechperfect. * days after this consu]tation i _ informed Jthe eid^ ^ ^ On examination, for the sake of compa- rison, of the amount of voluntary power possessed, the principal difference is that the younger child can more readily and more completely effect the same move- ments as the elder. The younger, when placed on the ground in the kneeling pos- ture, the elbows and body resting on the edge of a chair, can support himself for three or four minutes in that position, and approach the right knee four or five inches towards the chair, but cannot, even in this position, effect locomotion.