Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright.

  • Wright, G. A. (George Arthur), 1851-
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the ischiofemoral band and the intertrochanteric line. Another weak spot lies in front, where the branch of the external circumflex artery p'asses into the joint. 9. The parts of the capsule on which strain is thrown in the different movements of the joint. a. The thin inner and posterior part of the capsule is made taut in extreme flexion with abduction; hence the pain in that movement; the pectineo-femoral band is tightened at the same time. b. The frequent communication of the psoas bursa with the joint through the thin triangular space between the ilio- and pectineo-femoral bands. 10. The ligamentum teres is loosest in flexion and abduction combined. 11. The cartilage capping the head of the femur is by no means all articular in the sense that it forms part of the bearing surface. A considerable zone of cartilage extends around the rest, and is covered more or less perfectly with synovial membrane. Through this zone, which may be called the marginal cartilage, numerous vessels pass, and in disease these are often large, though in health the supply is less obvious* The vessels are appa- rently derived from the synovial membrane, and in some cases, no doubt, inflammation spreads along their channels and reaches the synovial tissue. So far as I know, these facts are not sufficiently, if at all, recognised. The articular cartilage is especially thick round the insertion of the ligamentum teres, to which it is so closely attached that it may be torn away with the ligament in case of dislocation. The ligamentum teres forms as it were a channel through the articular cartilage to the bone, a fact of great importance, since, as will be seen subsequently, disease beginning in the bone may take this course towards the joint cavity. 12. The vascular supply to the joint need not be speci- * This marginal cartilage often persists after destruction of the articular surface, and remains of it may be seen in Figs. 6 and 10.