II. CAUSES OF CRIPPLED CONDITIONS: 

 ENUMERATION AND DEFINITIONS^ 



Deformities occurring in children can be traced to four 

 general causes : disease, congenital condition, accident, and 

 incorrect posture. A brief enumeration of the diagnoses aris- 

 ing from these fundamental causes and a definition of each 

 will perhaps be illuminating as a background for the discus- 

 sion of the social aspect of crippled children. 



1. Tuberculosis of Bones and Joints. This disease is re- 

 sponsible for a large percentage of crippled children. It oc- 

 curs most frequently in children from three to ten years of 

 age — during the time when accidents are most apt to occur, 

 and when rapid growth decreases constitutional resistance 

 against possible infection. The prognosis depends on the in- 

 herited constitution of the patient, and the environmental 

 treatment — including rest and nutrition — which he receives. 

 Cases receiving proper treatment and general care soon after 

 the diagnosis is made stand a good chance of recovery. This 

 disease attacks the lower extremities and the spine most fre- 

 quently. 



Tuber ciilosis of the Spine, or PoWs Disease, is subdivided 

 into dorsal, lumbar, and cervical Pott's Disease. 'The etiol- 

 ogy or causation in at least one-half the cases is traceable to 

 some slight injury to one or more of the vertebrae."- During 

 the course of the disease abscesses may or may not appear 

 and eventually the typical ^'hunchback" condition develops 

 ''unless the destructive process is promptly checked".- Early 

 treatment by recumbency in a frame, plaster jackets, steel 

 braces, and occasionally surgery gives a fairly favorable prog- 

 nosis in young subjects. 



Tuberculosis of the Hip is located in the head of the femur, 

 and the first sign of its presence is shown by stiffness and 

 lameness, formation of abscesses, and a gradual shortening 

 of the leg. Treatment by fixation, plaster casts, braces, and 

 surgery will result in a probable cure of the tuberculous con- 

 dition, but will leave the hip more or less stiff for life. Double 

 hip joint disease is included under the diagnosis of tubercu- 

 losis of the hip, and is treated in the same way, the chances 

 for recovery being somewhat less. 



^ Bradford and Lovett, Orthopedic Surgery. 

 2 Quotation from Dr. John H. Oliver. 



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