Distraction in the treatment of hip disease / by Edward H. Bradford and Robert W. Lovett.

  • Bradford, Edward H. (Edward Hickling), 1848-1926.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Distraction in the treatment of hip disease / by Edward H. Bradford and Robert W. Lovett. 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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    EXPERIMENTS UPON CADAVERA. 1. Normal Joints.—The hip of a full-termed foetus was prepared in such a way that the skin was removed so as to expose the muscles around the hip. It was found that under a slight amount of traction distraction was possible. This was not only visible to the eye, but it was also demon- strable on a specimen on which the skin was removed without disturbing the ligaments or muscles. A needle was inserted in the head of the femur and another in the ilium slightly above the acetabulum, a slight amount of force, separating the two needles. An adult dissecting- room specimen was taken, the femur amputated below the trochanter, and the pelvis fixed. The skin was not removed and a traction force was applied. Needles were inserted into the femur and into the ilium, the skin and muscles being incised in such a way that the traction force would not disturb their relative position. Traction of a hundred pounds was applied, and it was found that the needles were separated an eighth of an inch. After the specimen had been soaked in weak alcohol for some time distrac- tion of an eighth of an inch was easily effected by a pull of five pounds. On a large amount of material placed at our disposal by Professor Dwight, of Harvard College, it was clearly shown that traction distracted in all cases of femora in children dissected or undissected, and in all specimens of infants, and that the checks to distraction in adults in cadavera lay in the resistance, first, of the capsular liga- ment, especially of the anterior bands of the ilio femoral ligament; second, in the resistance of the cotyloid liga- ment, and to a slight degree in atmospheric pressure. In children the lower edge of the acetabulum presents no re- sistance to a traction in the line of the axis of the body. (See Fig. 5). In adults this presents a resistance, but if the limb is abducted the resistance is avoided. Both in children and in adults, if the femur is extended to its ut- most, limit, the anterior bands of the ilio-femoral ligament l}ing on the front of the capsule prevent all distraction on any force which it is feasible to apply. If the capsule and cotyloid ligaments are disorganized, distraction is easy.