The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . ds, and has shown the depend-ence of both events upon the par-ticular direction of the nutritiousarter3^ Thus, the humerus growsmainly from its upper epiphysis, and the bonos of the forearm from the epi-physes near the wrist, while in the lower extremity the growth of both legand thigh is chiefly effected by the ei»iphyses in i)roximity to the the risk of hindered gro^^•th after excision is comparatively slight atthe elbow, hip, and ankle, and is most to be dreaded in operations
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . ds, and has shown the depend-ence of both events upon the par-ticular direction of the nutritiousarter3^ Thus, the humerus growsmainly from its upper epiphysis, and the bonos of the forearm from the epi-physes near the wrist, while in the lower extremity the growth of both legand thigh is chiefly effected by the ei»iphyses in i)roximity to the the risk of hindered gro^^•th after excision is comparatively slight atthe elbow, hip, and ankle, and is most to be dreaded in operations at theshoulder and wrist, and, above all, at the knee, since shortening is of muchgreater consequence in the lower than in the upper extremity. On the otherhand, since at the knee firm, bony union is sought for, it is less important topreserve the periosteum in excisions of this joint than in those of the otherarticulations, where it is wished to preserve the power of motion, and where,therefore, a more or less perfect reproduction of the articulating extremitiesis hoped for. VOL. IV.—20 restmg. f Deformity from injury of radial epiphysis. 450 EXCISIONS AJMD RESECTIONS. Repair after excision of the knee, or after any other excision whicli is fol-lowed by bony union, and repair alter resection in the (continuity of the longbones, is eliected in the same manner as repair after conipound sawn ends of the bones undergo a retrograde metamorjihosis into granu-lation-tissue, and the granulations from the ajiproximated surfaces coaleseing,osseous matter is again dejiosited, and in time complete synostosis results. Inthe case of the shoulder, hip, or ell)()w, though, in some few instances, a newcapsule, and even a new synovial membrane, seem to have been formed, in theimmense majority of cases union of the resected bone-ends is effected throughthe medium of strong cicatricial bands, analogous to those met with in fibrousanchylosis. A similar substance fills the gap af
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