Notes on the dissection of a case of congenital dislocation of the head of the femur / by Francis J. Shepherd.

  • Shepherd, Francis J. (Francis John), 1851-1929.
Date:
[1880?]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on the dissection of a case of congenital dislocation of the head of the femur / by Francis J. Shepherd. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    NOTES ON TI-IE DISSECTION OF A CASE OF CON- GENITAL DISLOCATION OF THE HEAD OF THE FEMUR By Eii.vNcis J. Shepherd, M.D., C.M., M.H.C.S., Eng., Demonstrator of Anatomy, M'Gill University, Montreal. A FEMALE subject about 50 years of age was brought to the dis- secting-room of M'Gill University in the autumn of 1879 in whom it was noticed that the right leg was smaller and shorter than the left, and everted. The woman was very stout, and the head of the femur could not be distinctly made out, but it was noticed that the trochanter was higher than usual; abduc- tion was limited, but otherwise the joint was freely movable. The tuberosity of right ischium was quite subcutaneous, the muscles appearing as if carried up with the trochanter-major. Amount of shortening, 2 inches. The exact nature of the lesion was not made out from an external examination, and it was only on dissection of the part that it was discovered to be a congenital dislocation. Dissection.—There are no scars to be seen on the skin of gluteal or femoral region, indicating that old sinuses had existed, the skin is perfectly smooth. On removing the skin and fascia of the gluteal region, the fibres of the gluteus maximus, and gluteus medius muscles are found to be shorter than normal, their points of origin and insertion being approximated; the muscular tissue is much altered, in some places being com- pletely changed into fatty tissue. I may here remark that aU the muscles of the body have become fatty degenerated to a greater or less extent, but this condition is much more marked in some of the muscles about the affected hip. On removing the two superficial gluteal muscles (between which a lot of fat is seen), the quadratus femoris, obturator externus, gemelli, and obturator internus are brought into view. These muscles, instead of passing transversely outwards to get to their insertion, pass upwards ; the pyriformis is found to pass outwards and slightly upwards, instead of downwards. The gluteus medius, obturator internus, gemelli, and pyriformis in passing to their insertions go over the head of the femur. More of the obturator exteriuis is