[Illustration: FIG. 118.--Thomas' Hip Splint applied for disease of
Right Hip. Note patten under sound foot. The foot on the affected side
is too near the ground.]

In children who are unable to use crutches, a double Thomas' splint is
employed; the child thereby is converted into a rigid object, capable
of being carried from one room to another and into the open air.
Personally we have obtained satisfaction from the double Thomas'
splint employed for spinal disease, which extends from the occiput to
the soles of the feet.

The fixation of the hip-joint and the taking of the weight off the
limb by one or other of the above methods, should, as a general rule,
be continued for at least a year.

Should an abscess develop, it is treated on the usual lines.

_Operative Interference._--Widely diverse opinions are held on the
question as to whether or not recourse should be had to operative
interference.

Some surgeons are opposed to operative interference, on the grounds
that however advanced the disease may be it will yield to conservative
measures if judiciously and perseveringly carried out. Other surgeons
advocate operative treatment in all cases which do not speedily show
improvement under conservative treatment. An intermediate attitude may
be adopted which recommends operation in cases in which the disease
progresses in spite of conservative treatment, and in which periodic
examination with the X-rays shows that there are progressive lesions
in the upper end of the femur or in the acetabulum.

It is claimed by those who advocate operation under these conditions
that pain and suffering are at once got rid of, sleep is restored,
appetite returns, and there is a marked improvement in the general
health, and that this result is obtained in months instead of years,
and that the cure is more likely to be permanent. It is certainly
unwise to delay operation until sinuses have formed, as such a course
is largely responsible for the bad results which formerly followed
excision of the joint.

_Amputation_ for tuberculous disease of the hip has become one of the
rarest of operations, but is still required in cases which have
continued to progress after excision, and when there is disease of the
pelvis or of the shaft of the femur, with sinuses, albuminuria, and
hectic fever.

#The Correction of Deformity resulting from Antecedent Disease of the
Hip.#--From neglect or from improper treatment, deformity may have
been a