Hip

Hip. The hip joint is a typical ball-and-socket joint. The socket of the joint is formed by a depression which exists on each side of the outer aspect of the pelvis, and is called the acetabulum.- in this depression the rounded head of the femur or thighbone rests, being retained in its place by a series of ligaments, one of which, the capsular ligament, is attached, on the one hand, around the edge of the acetabulum, and, on the other, to the neck of the femur just beyond its head, enveloping the latter and limiting the extent of the joint cavity. The movements at the hip joint are very free. The joint is deeply situated, and thus escapes many forms of disease which affect more superficially situated joints. The principal affections to which it is subject are as follows: - Dislocat ionoi the hip may occur in four different directions. The most common form is dislocation of the head of the femur upwards and backwards. The symptoms are distortion, inability to move the joint, the limb is shortened, and the head of the femur can generally be made out in its displaced position.

Diseases of the Hip. The hip is not uncommonly affected by the disease known as osteo-arthritis. The joint is, as might be expected, often involvedin fractures of the neck of the femur. The most important diseased condition affecting the hip, however - "hip disease "par excellence - is what is known as strumous disease of the hip joint. This malady particularly affects children and young adults. The chief symptoms are pain (which, curiously enough, is sometimes felt in the knee joint, although it is the hip and not the knee which is at fault), lameness, a distorted position of the leg with respect to the body, and limitation of the power of moving the joint, the muscles of the affected limb waste, and when the disease becomes established collections of matter occur in the neighbourhood of the joint. Early treatment of the disease is most imperatively called for, as, if abscesses are allowed to form, psnt-up matter burrows deeply into the tissues, causing much damage and disorganisation before it makes its way to the surface. In neglected cases of hip disease amyloid degeneration of the liver, spleen, and kidneys is apt to supervene; tubercular meningitis, and tubercular disease affecting other parts of the body may occur as complications. Treatment consists in keeping the patient absolutely at rest in the recumbent posture, splints are applied to the legs, and an attempt is made to gradually correct the deformed position of the affected limb by the application of what is called extension. A weight is adjusted by means of a pulley so as to continually exert tension in the appropriate direction yepon the limb which is involved, and this process of extension requires, as a rule, to be kept up for some months. If collections of matter form, the pus must be evacuated under suitable antiseptic precautions, and in some instances of advanced hip disease it is deemed necessary either to remove the diseased tissues (excision of the hip joint) or to amputate the limb.