American practice of surgery : a complete system of the science and art of surgery . ce of the growth, and, of the 5 surviving, but 1was well for a period of over three years. In the central giant-cell form (Fig. 204) curetting is to be recommended,as amputation can be done later, if necessitated by a recurrence of the , if the tumor is small, will give the same result as in other diseasesin which resection of the knee joint is practised, but it is generally necessaryto remove more bone than is required under other circumstances, and the legis consequently much shortened. Out o
American practice of surgery : a complete system of the science and art of surgery . ce of the growth, and, of the 5 surviving, but 1was well for a period of over three years. In the central giant-cell form (Fig. 204) curetting is to be recommended,as amputation can be done later, if necessitated by a recurrence of the , if the tumor is small, will give the same result as in other diseasesin which resection of the knee joint is practised, but it is generally necessaryto remove more bone than is required under other circumstances, and the legis consequently much shortened. Out of 20 cases of central sarcoma of thehead of the tibia, in which various operations were performed and the final re- 464 AMERICAN PRACTICE OF SURGERY. suit was ascertained, nearly 50 per cent were living at the terminationof fully three years, while 9 others had remained well for periods ranging fromone to two years, and only 2 were known to have died of a recurrence of thegrowth or of metastases i Butlin). Fibula.—The fibula is comparatively rarely attacked, and the usual rules. Fig. 204.—Central Giant-cell Sarcoma of the Head of the Tibia (Spina Ventosa). (WarrenMuseum. Harvard Medical School.) regarding treatment of the various types of growth apply with equal forceto these cases. Resection should be given the preference over curetting forcentral tumors of any appreciable size, as it causes but little disability (). TUMORS ORIGINATING IN BONE. 465 MULTIPLE MYELOMA. Synonyms: osteomalacia, myelogenous pseudo-leukaemia, sarcomatous ostei-tis, lymphadenoma, hyperplasia of the marrow, etc. Definition.—A primary, multiple neoplasm of the bone marrow affectingchiefly the sternum, ribs, vertebra?, and skull, and, more rarely, the long bonesof the skeleton. The growth replaces to a greater or less extent the bony tissueand may infiltrate the soft parts in the immediate neighborhood, but it differsfrom other malignant growths in that it never forms metastases in the soft
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