Report on morbus coxarius, or hip disease / by Lewis A. Sayre.

  • Sayre, Lewis A. (Lewis Albert), 1820-1900.
Date:
1860
Catalogue details

Licence: Public Domain Mark

Credit: Report on morbus coxarius, or hip disease / by Lewis A. Sayre. 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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    section of the joint not only justifiable, but in most instances ab- solutely essential. . , Under similar condition of other joints, more especially where the disintegration is of but limited extent, I have freely opened them, inserted setons through them, injected them with iodine, and attained thereby satisfactory results. In some instances I have even had perfect recovery, with free motion of the joint But the same principle of free incision seems not to be applica- ble to the hip-joint; since the conformation of the joint, its deeply seated situation and investment with soft parts opposes the free exit of the discharge. In fact, the hip-joint can hardly be said to be freely opened without removing the head of the femur, which fills it completely. Third Stage.—We have invariably in this stage of the disease a rupture of the articular apparatus either of the capsule, or a per- foration of the acetabulum, but the character of the disease differs widely whether inflammation and plastic lymph caused the rup- ture or whether ulceration of cartilage and bone and consequently purulent effusion brought about that change. In the former the lympb escapes into the cellular tissue, spontaneously relieving the hydraulic pressure of the joint, and the most prominent symptoms, and in fine organizing itself into new tissue, leaving, however, ad- hesion of the joint, and the extremity in a state of malposition, thus effecting a spontaneous cure. This variety of the disease is by no means rare, and has led many a surgeon to rely on the sim- ple efforts of nature more than on surgical art. Nor do I propose for such cases any active interference, but only the contrary. I only suggest to assist nature in effecting this spon- taneous cure by mechanical appliances in relieving the joint from pressure, in permanently distending the morbidly contracted muscles, and in fine in securing the perfect mobility, usefulness, and normal position of the extremity. If the cure has been thus effected by the unaided efforts of na- ture, it is invariably done by a fibrous anchylosis of the joint and the characteristic malposition of the extremity previously described. Even this result of the disease formerly considered as an incurable spontaneous luxation, though the most fortunate termination that was to be expected in this disease has now been brought within the scope of surgical art, and is susceptible of perfect relief. The division of the contracted muscles implicated in the defor-