The sun. [volume] (New York [N.Y.]) 1833-1916, 1902-12-14
TIL" I.orenz Operation.

III" I.OrenZ tp"rdtlon
Prof. ADOLF LoREN7. Nienna's cele-
brated rth 'padic specialist, Will max"
the first demonstration of his well-known
operation for the relief Of congcniial dis
location Of the h,p john, in New York
medical college, in the surgical ainphi-
theatre of the New York Polytechnic Mcdl-
cd School and Hospital on Tuesday. Dec.
&c The audience will he composed of
physicians from all ~cctlO of The coiln-
try who are now students AT th,s school,
TIE uedlcal faculty aid trustees of the
institution and a number of distinguished
surgeons of New York city. 50 much
iuterc-t has been aroused throughout the
| ntcd States by the visit of this surgeon
ilat description Of 'hr dciurutv which
, is intended to relieve completely or
partially AMI Tn" mdhpd Of procedure
ill no doubt interest the readers Of
THE SIN
In the carly development, Of a child
the three bones which are TO form the
large hip bone of one side of the body are
not united but grow separately and grad
u1liy be come hardened and united Whom
development i natural and complete the
point where these three bones join is in
tho bottom OF "A cup-shaped cavity, called
tue socket. in which the rounded head
of the thigh bone is held hy strong liga-
'nents If, from any cause. develop
Inent is ntcrfered with, a failure almost
always takes place where this cup-shaped
cavity or socket should be- When there
Is NJ well-developed socket To hold the
lead of the thigh in place the strain On
tho ligaments whel the child begins TO
walk is so great that they are stretched
aSnprmllly. AMI finally there is a dis
placement Of the head Of the bone
through the insufficient capsule The
surgeon has therefore to deal not only
with dislocated joint, but an undcvel-
oped socket, and the operation is in
tended 10 bring the head of the bone TO
Inc place whore the depression should
be. and 70 hold il well against the soft
tned tissues at the proper point until
by pressure II forms a more or less COM
piete socket. More satisfactory results
ARE looked for in children under 5 or 6
N'di VI i-,' 'iltii III li''Nt ~ arc i''.
For the operation the child is made in
sensible and unconscious by an anps-
thctiC, and is placed upon firm table,
squarely upon the back, while the pelvis
or hip bones Of both sides of the body are
held immovable by the hands Of assist
ants, The operator, holding the thigh
firmly. bends it AZ the hip and upon the
- . -,
perpendicular to the level of the table.
IL is then carried slowly and forciblv
outward or away from the middle line
uf the patients body, then swaved to
and fro with gradually increasing force
until by stretching or tearing the muscles
and ligaments at the joint. it is carried
outward so far that the thigh is almost
parallel with the surface OF the operating
table, When, by this mannuvre, the
muscles and capsule have been suffi-
GENTLY stretched or torn, the head of the
bone, which is now near the place where
the socket should be. NAV be felt to have
slipped over the edge of this shallow saul
Ger and into the slight concavity Fail
ing in this, the same movements are re-
pea'od, the limb being carried still further
in 49," various directions above given.
When finally the head Of the bone is felt TO
have passed into the depression for the
socket, II is carefully held in this posi-
ton and an effort made to deepen the
socket by semi-rotation of the bore from
right to left, boring the head Of the thigh
into and deepening the cavity. A plaster
of paris enCasement is now applied and
worn for from six to nine months. After
week or two, or as soon as the sensitive
ness OF the joint will permit, the patient
is encouraged to walk upon the leg of the
affected side
Although this is called bloodless OPP
GRAFTON, 1t is probable that the bleed
ing which takes place beneath the skin
as a result of the laceraton of the blood
vessels is not less than that which occurs
when the operation in the hands of a
competent surgeon is done by direct in
cision, and the bone replaced with that
exactness which vision assures.