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Related post: vaginae femoris. "When this had been done, the thigh was
immediately and readily extended to a right line with the
body. The patient was put to bed, and the limb kept ex-
tended Antivert 25 Mg Antivert 25mg by a weight attached to the foot. No inflammation
followed the operation ; and, on the tenth day, when the dress-
ings were removed, the wound was found to have healed com-
pletely, and without suppuration.
The patient was confined to bed for six weeks, in the hope
of obtaining bony anchylosis in the straight position ; but, as
it was found, at the end of that time, that the parts remained
freely movable, he was permitted to get up, and to move about
the ward on crutches. Meanwhile, the right limb, which,
G12 CLINICAL RECORDS.
immediately after the operation, was of equal length with the
left one was found to have shortened a quarter of an inch.
The patient was discharged from the hospital on April
29th, and returned to the city for a day only on August 15th,
when the ahove photograph was taken. At that time he was
still obliged to get about on crutches, and showed little power
over the false joint, which yet remained quite movable.
During the winter of 18T2-'73 he was again attacked with
rheumatism, and confined to bed for several months. The
disease was especially severe in the right knee, which, on his
return to the city in February, 1873, was found to be in a
state of false anchylosis. lie was admitted into the Roose-
velt Hospital, where an attempt to flex the knee brought on
a sharp attack of synovitis, which lasted until May 1, 1873.
Since then, he has been steadily improving in general health,
and has acquired the power of locomotion to a useful degree.
He can walk without the assistance of a cane, but his gait is
then awkward and unsteady, owing, he says, rather to a weak-
ness of the knee than of the hip. With the aid of a cane,
however, he walks quite well, and, for distances not exceeding
a mile, without fatigue. The aifected limb is three-quarters
of an inch shorter than its fellow, and the existence of a false
joint is plainly demonstrable, as the members of the Society
can convince themselves on examining the patient. He sits
with ease in the upright position, and, while standing erect,
can cause Antivert Meclizine the right foot to move as follows : forward, twenty-
two inches ; backward, nineteen inches ; inward, thirteen
inches ; and outward, fifteen inches. In making the move-
ment of adduction, he is able to bring the limb across the
opposite knee. Rotation, to about its normal extent, can be
easily efiected by passive motion, but the patient has very
little voluntary power in producing this movement. In walk-
ing, the foot Antivert Otc is naturally everted. To what extent further
improvement is possible cannot, ot course, at present be de-
termined, yet the patient is steadily gaining, and expresses
himself highly pleased with the result already obtained.
Cases of bony anchylosis at the hip-joint have rarely been
treated by surgical operation ; and, until the ingenious plan
•of subcutaneous osteotomy was recently devised and executed
CASE OF BONY ANCHYLOSIS OF THE HIP-JOINT. 613
by Mr. Adams, tlie operations hitherto performed were of a
formidable character, and involved very extensive incisions
into the soft parts. The first operation ever undertaken Cheap Antivert for
the relief of bony anchylosis at the hip-joint was performed
by Dr. Khea Barton, of Philadelphia, in 1826. It was begmi
by a crucial incision, seven inches in length, and five inches
in width, laying bare the great trochanter. The soft parts
then having been separated from the bone, the latter was
divided horizontally through the great trochanter and neck
of the femur, above the lesser trochanter. The patient recov-
ered with a useful limb, and the false joint thus established
remained movable Meclizine Antivert during six years, after the lapse of which
period it became anchylosed in the straight position.
It has been alleged * that Dr. Barton's operation was under-
taken merely for the purpose of rectifying the malposition of
the limb, and not with the view of establishing a false joint ;
that the section was made through the shaft of the femur,
below the lesser trochanter, and that a wedge-shaped piece of
bone was removed. All of these statements are erroneous, as
may be seen by consulting the original paper of Dr. Barton,
already referred to.' The operation was performed, as I have
described it, and for the expressed purpose of creating an arti-
ficial joint. Moreover, the joint thus obtained retained its
mobility during a period of not less than six years. Barton's
operation has since been performed by Rogers, Textor, Maison-
neuve, Ross, and others, always with the result of correcting
the deformity, but seldom with that of establishing a false
joint for any great length of time.
In 1862, Dr. Sayre operated upon two patients with anchy-
losis of the hip, by a method which resembled Barton's, but
which differed from it in the fact that it involved the excision
of a semicircular piece of bone. One patient, after the ex-
foliation of two pieces of dead bone, recovered with a service-
able false joint, which exhibited free motion six months after
the operation, when he left the city and returned to his home.
In the case of the second patient, the wound closed at the end
* "A New Operation for Artificial Hip-Joint," etc. By Lewis A.
Sayre, M. D., New York Medical Joubnal, January, 1869.
* North American Medical and Surgical Journal, vol. ili., p. 279.
61-1 CLIXICAL KECORDS.
of four months, but afterward reopened, and discliarged sev-
eral small fragments of dead bone. The patient died of dis-
ease of the Antivert Price lung about six months after tiie operation, and, at
the autopsy, the existence of a false joint was verified.
Mr. Adams, Antivert 25 in the paper referred to, reports seven cases
of the operation devised and first performed by him. Of
these, six were successful, Antivert Canada the other terminating fatally from
pyaemia. This latter case was one of fibrous, while the former
were all examples of bony anchylosis. Of the Antivert 12.5 Mg successful cases,
two ended in anchylosis at the ex'piration of two months and
five months respectively ; in the remaining four, the final
result, as regards motion, cannot be definitely stated, as two
of them were reported five weeks, one four months, and on6
eleven months, after the operation.
I think it Buy Antivert will be found that, in cases of bony anchylosis
of the hip-joint requiring a surgical operation, the simple
method recommended by Mr. Adams will supersede all others,
on account of its safety, and of the facility with which it can
be carried out. The question, whether operations of this
character may be expected to result in the formation of an

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