Cases in orthopedic surgery.

Buckminster Brown.

Case XX. Photographs Nos. 1 and 2.

The last case, of which I have to speak this morning, is that of a girl twenty years of age, whose situation before treatment is shown in this photograph. (See Case XX., Plate VIII., figure 1.) When eleven years old, while at play, she was thrown from a height of sixteen feet, by the caving in of an embankment, the lumbar and sacral spine striking upon a large stone. The fall produced insensibility for a few moments. She then recovered and went to school. She continued her usual avocations for five or six weeks, growing, daily, more and more feeble. She was then attacked with agonizing pain in the lumbar region, followed by complete loss of sensation and motion below the hips. The thighs and legs gradually contracted, until the left knee was drawn up to an acute angle with the body, and twisted to the right. These parts were in such close contact that it was with difficulty I forced the knee from under the thigh where it had lain for years. The patient had extreme lateral curvature, with excessive incurvation of the lumbar vertebrae. The first photograph was taken nine years after the accident. By means of subcutaneous division of tendons in the groins, popliteal regions and in the feet, followed by mechanical appliances, together with a carefully adjusted spinal apparatus, the girl was in three months straightened out as seen in the second representation. (See Case XX., Plate VIII., figure 2.)


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