444 



SURGICAL APPLIED ANATOMY, [chap. xix. 



could only separate the articulating surfaces about 



one-fifth of an inch. 



3. The lordosis, or curving forwards of the 



spine, occurs in the dorso-lumbar region. It depends 



upon the flexion of the limb, and is the result 



of an attempt to con- 

 ceal that false posi- 

 tion, or at least to 

 minimise its incon- 

 veniences (Fig. 3 9 A). 

 When the thigh is 

 flexed at the hip by 

 disease, the lower 

 limb can be made to 

 appear straight by 

 simply bending the 

 spine forwards in the 

 dorso - lumbar region 

 without effecting the 

 least movement at the 

 disordered joint. In- 



a 



deed, the movement 

 proper to the hip is in 



Fig. 30A. Diagram to show the Mode of ii , QCO 

 Production of Lordosis in Hip Disease. ' 



A, Femur flexed at hip, pelvis (represented by to the 

 the dotted line) straight, and spine 

 normal, u, The flexion concealed or 

 overcome l>y lordosis of the spine ; the 

 pelvis rendered oblique. 



spine. A 

 patient with a flexed 

 hip as the result of 

 disease can lie on his 



back in bed, with both limbs apparently perfectly 

 straight, he having concealed the flexion, as it were, by 

 producing a lordosis of the spine. If the lordosis be 

 corrected, and the spine be made straight again, then 

 the flexion of the hip reappears, although all the time 

 the hip joint has been absolutely rigid. This lordosis 

 generally appears a little late in the disease, and after 

 the limb has become more or less fixed in the false 

 positions by contraction of the surrounding muscles. 



