In the above, and in many other cases, the shortening of the neck of
the bone is unaccompanied by any absorption of the articular cartilage
of its head. A section of another well marked specimen may be here
added. This bone also exhibits approximation of the head to the shaft,
from absorption of the neck. The head is somewhat flattened and
expanded, but the articular cartilage is entire, and of its natural
thickness. The acetabalum was diminished in depth, but enlarged
laterally, so as to correspond with the alteration of shape in the head
of the thigh-bone. The preparation was obtained from a man at 32, who
died at the General Hospital at Chatham of pulmonary consumption, after
a confinement of two years in hospital. Previously to his admission,
he had regularly performed his duty as a light infantry soldier, from
which it is plain that his limbs were then of equal length, although,
when the body was examined, the affected femur was upwards of one inch
and a half shorter than the other. From a careful inquiry after his
death, it appeared that he had, five years previously, fallen on the
trochanter, in consequence of which he often complained of pain in
the hip, but continued to do his duty long after, never having been
confined on account of the accident. It therefore results, that morbid
change had taken place during his long confinement in hospital, a
circumstance not very favourable to the recommendation by some surgeons
of the horizontal posture, as a remedy in such cases, and equally
adverse to the opinion of certain continental pathologists, who inform
us, that shortening of the neck of the femur is to be attributed to the
gradual operation of the superincumbent weight of the body.
[Illustration]
In old subjects, particularly in fat women, the neck of the femur is
often shortened, and becomes more transverse and brittle than natural,
from a true interstitial absorption or atrophy of the osseous tissue.
This has sometimes been described as a natural effect of age, but it
is undoubtedly disease, for in the greater number of old people the
neck of the thigh-bone presents its usual length and obliquity. The
affection is obviously a very serious one, as predisposing to fracture
of the part, under circumstances which render its reunion almost
hopeless.
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