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TUBERCULOSIS OF THE HIP IN CHILDREN: A Review of Terminal Results At Canton.

SMITH, LEMUEL D.
The Journal of Bone & Joint Surgery: July 1926
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The regime at Canton maintains the vitality of the patient at the highest possible level. To this end the treatment is constitutional rather than local. The diseased hip is protected from weight-bearing but not from motion with a Bradford abduction traction splint. General freedom of activity is encouraged as soon as the symptoms of acute spasm and pain subside.

The condition of the diseased hip corresponds very closely to the general condition.

In all cases where ankylosis is now present or expected the disease was well advanced and destruction was marked before admission to Canton.

In all cases progress of the disease was promptly arrested when placed under this regime.

The results attest the importance and the virtue of a nice balance of all hygienic measures without stressing any particular agent. It seems to prove that the therapy of the sun is potent at our latitudes, under conditions where its ultra-violet rays are usually weakest, i.e., at low altitude, inland from the seashore.

Twenty-two per cent. of all the cases have come through with articular surfaces likely to be useful as true joint surfaces. Findings at Canton seem to indicate that this proportion would be markedly larger should the patient be placed under this regime at the incipiency of the joint lesion. We have no proof that these were tuberculous lesions of the joint but the clinical signs and symptoms had led to this diagnosis.

Atrophy seems proportional to degree of disuse and not to the virulence of the disease.

The relation of posture to structural scoliosis does not appear to be intimate. All but those retaining functional joints present a marked and some an extreme compensatory scoliosis and lordosis. In none of these cases has any appreciable structural change taken place in the spine.

The increased effective length of an abducted thigh is without advantage in view of the lurching, ungraceful gait incidental to it and abduction is to be avoided.

(C) 1926 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.

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