THE TREATMENT OF FLEXION AND ADDUCTION DEFORMITY OF THE THIGH BY CHANGING THE ANGLE OF THE FEMORAL NECK

We see that of the many operations devised to correct flexion and adduction deformity only two, the Adams operation and the Gant subtrochanteric osteotomy are still largely in use. Of these the most used is the Gant. This operation has many good points—notably, its simplicity, lack of injury to soft parts, distance from infected area and consequently less danger of lighting up old disease. It is less apt to be followed by a return of the deformity. On the other hand, it has several disadvantages. the most important of these are, the fact that one is working in the dark and that it is often very difficult to find the lower end of the trochante. so that frequently the line of division is an inch or more below. As a result a very bad angle is produced in the shaft. The line of weight-bearing is not transmitted in a straight line, which is a bad mechanical principle.

In contrast to this, the operation consisting of a semi-circular division of the femur at the trochanter has only one or two disadvantages which have been answered, and these are not as serious as those raised against the other operations. It has several advantages which seem to indicate that it might well be used as a substitute for both the Gant and the Adams. The greatest advantage is that mechanically the principle seems correct. Very severe deformities have been corrected, and at the same time the X-ray does not show any awkward carrying angle.

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