et been decided whether the results of the
resection of nerve roots justify the risk.

Apart from Foerster's operation, or when it has failed, the spasm of
any individual muscle or group of muscles may be got rid of by
diminishing the nerve supply to the muscle or by lengthening the
tendon. Diminishing the nerve supply was suggested by Stoffel; it
consists in exposing the motor nerve as it enters the muscle and
resecting one-third or one-half of the fibres so as to reduce the
innervation to the required degree. The method is still on its trial.

_Lengthening the Tendons._--In spastic paraplegia, for example, Jones
resects the origins of the adductors longus and brevis, lengthens the
tendo Achillis, divides the popliteal fascia and hamstrings, and
transplants the biceps into the quadriceps; after which the limbs are
put up in the attitude of wide abduction for six weeks. It is
important that the patient should begin to walk with the legs wide
apart and learn to balance himself without any feeling of insecurity;
he should be taught to look at an object straight in front of him
rather than on the ground.

THE LOWER EXTREMITY

CONGENITAL DISLOCATION OF THE HIP

This is the commonest of all congenital dislocations. Its frequency
varies in different countries, being greater on the continent of
Europe than in this country. It is more often unilateral than
bilateral (about 4 to 1), and is about three times more common in
girls than in boys.

The dislocation takes place in the early months of intra-uterine life,
and may be associated with deficiency of the liquor amnii.

#Pathological Anatomy.#--_In the infant_, the anatomical changes in
the joint are less marked than they are after the child has borne its
weight on the limb. The acetabulum, never having been occupied by the
head of the femur, is imperfectly developed; it remains flat and
shallow, is partly filled with fibro-fatty tissue derived from the
synovial membrane, and is always too small for the head of the femur.
The cotyloid ligament being broader and thicker than usual, makes the
osseous portion of the socket appear deeper than it really is. In
unilateral cases the affected half of the pelvis is contracted, so
that the pelvic basin is narrowed and oblique. The head of the femur
is small, flattened, and, in some cases, conical; and the angle formed
by the neck with the shaft is altered, sometimes diminished, it may be
to a right angle--_coxa vara_ (Fig. 1