A Treatise on Orthopedic Surgery

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Lea & Febiger, 1910 - Orthopedics - 892 pages
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Page 738 - ... of weakness that have been described those cases of extreme deformity in which the symptoms are disabling and in which the foot is rigidly held in the deformed position by muscular spasm. Such cases, often considered hopeless as regards a cure, or even relief, are in reality the most satisfactory, and in no other type of painful deformity can so much be accomplished by rational treatment as in this class. The...
Page 240 - Every change in the formation and function of the bones, or of their function alone, is followed by certain definite changes in their internal architecture and equally definite secondary alterations of their external conformation in accordance with mathematical laws.
Page 503 - The incision passes from the posterior border of the sternomastoid muscle, at the junction of its middle and lower thirds, downward and outward to the clavicle at the junction of its middle and outer thirds.
Page 197 - This exerts all the extensor muscles from the toes to the head in rapid succession. opposite the scoliosis the action of the back muscles, to sustain the weight and equilibrium, is such as to cause the curved spine to approximate a straight line. A similar result is produced when a heavy weight is held by the side of the erect body on the scoliotic side, the arm being at full length. When a heavy bar is raised above the head, with both hands, the patient must fix the eyes upon the middle of the bar...
Page 807 - Fig 4, are simply to keep the apparatus in place, which they do effectively if ordinary gum plaster is used, while, by drawing the middle strip, E, tightly over the shield, and straightening the brace from time to time, the deformity is gradually and gently reduced. At each re-application the brace is made a little straighter than the foot at that stage. This may readily be done by the hands, and then the adhesive strip is to be tightened over the shield, till the shape of the foot agrees with that...
Page 865 - ... tendons which are divided at the first stage of the operation are then attached to the insertion of the tendo Achilles and to the os calcis by strong silk sutures. The object of the removal of the astragalus is to secure stability and to prevent lateral deformity by placing the leg bones directly on the foot. The object of the backward displacement of the foot is to direct the weight upon its center and thus remove the adverse leverage which induces dorsal flexion. DISCUSSION. Dr. Henry Ling...
Page 691 - ... sternocleido-mastoid may spread to other muscles in spite of this operation. 5. No fear of disabling paralysis need deter us from recommending operation, as the head can be held erect even after the most extensive resection. 6. The most common combination of spasm is that involving the sterno,mastoid on one side and the posterior rotators on the other, the head being held in the position of sterno-mastoid spasm with the addition of retraction through the greater power of the posterior rotators....
Page 505 - Usually the junction of the fifth and sixth roots is the site of maximum damage. The thickened indurated areas are determined by palpation and are excised by means of a sharp scalpel. Scissors should never be used for this work. "The nerve ends are brought into apposition by lateral sutures of fine silk involving the nerve sheaths only, while the neck and shoulder are approximated to prevent tension on the sutures. Cargile membrane is wrapped about the anastomosis to prevent connective tissue ingrowth....
Page 691 - Operation on the spinal accessory nerve may afford relief, even if other muscles than the sternocleidomastoid are affected. On the other hand, the affection previously limited to the sternocleidomastoid may spread to other muscles in spite of this operation. 5. No fear of disabling paralysis need deter us from recommending operation, as the head can be held erect even after the most extensive resection. 6.
Page 739 - ... is flexed about and under the head of the astragalus, which is then lifted to the limit of normal flexion.

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