The management of the abscesses of hip disease / by A.B. Judson.

  • Judson, Adoniram Brown, 1837-1916.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The management of the abscesses of hip disease / by A.B. Judson. 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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    is supported by tlie fact tliat a large proportion of the sinuses found at the higher level leave scars which are directly attached to the subjacent bone. I have found but little evidence that the pus in hip disease follows the lead of muscular sheaths. It appears rather to take the shortest course toward the surface, influenced to a certain degree by gravitation. Scars resulting from sinuses have been ob- served directly attached to the femoral shaft, the great tro- chanter, the horizontal ramus of the pubes, the crest or the spines of the ilium, and the posterior surface of the sacrum. Scars thus attached to underlying bone impart a curiously dimpled appearance to the part of the body in which they are found, especially in subjects inclined to be fat. Wher- ever they appear, the sinuses do not interfere with the proper application and comfortable u’earing of the hip- splint, which makes pressure only where the perineal straps support the ischiatic and pubic bones. The pressure made by the straps forbids an eruption at these points. I have seen no case in which the pus has found an exit by the vagina or rectum. Dr. Gibney has reported an interesting case of the former kind,* and Dr. J. Eandolph j- and Dr. Edmund Andrews cases of the latter. Dr. Andrews remarks in regard to his patient (whose hip joint he had exsected): “This is the only instance which I ever heard of where a fistula in ano opened on the outer side of the thigh.” J In regard to the treatment of the abscesses of hip dis- ease, the histories of the cases under review indicate that the precept that pus should be released by an early and free incision is a rule which is not to be always followed in the management of the abscesses of hip disease. This opinion was ably maintained by Dr. John F. Ridlon in a discussion * “ The Hip and its Disease.^,” V. P. Gibney, New York, 1884, p. 181. f “American Jour, of the Med. Sciences,” February, 1831, p. 301. * “Chicago Med. Examiner,” June, 1861, p. 293.