Lectures on orthopedic surgery . ery rare except in children andyoung adults. In most cases inherited syphilis isacknowledged or reasonably suspected. In the carpusand metacarpus the bones become thickened, andabscesses develop early. In the fingers, it is usuallythe proxymal phalangeal joint that is affected; thedistal end of the first phalanx and the proxymal endof the second phalanx become thickened and the fingerassumes a spindle shape, suppuration occurs and evi-dences of tuberculosis are found; nevertheless thesecases respond to antisyphilitic remedies in a way thatmarks them as quite ap
Lectures on orthopedic surgery . ery rare except in children andyoung adults. In most cases inherited syphilis isacknowledged or reasonably suspected. In the carpusand metacarpus the bones become thickened, andabscesses develop early. In the fingers, it is usuallythe proxymal phalangeal joint that is affected; thedistal end of the first phalanx and the proxymal endof the second phalanx become thickened and the fingerassumes a spindle shape, suppuration occurs and evi-dences of tuberculosis are found; nevertheless thesecases respond to antisyphilitic remedies in a way thatmarks them as quite apart from ordinary tuberculousjoints. The mechanical treatment consists in splinting onthe palmar surface. The operative treatment consistsin subperiosteal erasion of the disease in the bones ofthe carpus and metacarpus, and in amputation of thefingers. If medicinal treatment is resorted to, rapidly-increasing doses of mercury and iodid of potash shouldbe given until the constitutional effects are producedor the disease Fig. 203.—Disease of the metacarpal bone and of the finger-bones,characteristic of inherited syphilis. RACHITIC DEFORMITIES. The chief rachitic deformities with which the ortho-pedic surgeon has to deal are : Bowlegs, knockknees,spinal curvature, and chicken-breast. The deformityknown as coxa vara will also be discussed, as well asadolescent rickets. The rachitic condition which leadsup to these deformities will first be considered. Rickets, or rachitis, is a disease of early is chiefly characterized by distortion of some or allof the bones. The distortion is due to irregulargrowth and deficient rigidity of the bony structure. The etiology of rickets is obscure. Many causes havebeen assigned by different observers, and any one, orall, may be the chief etiologic factor in any given disease rarely develops after the third year of life;by far the greater number of cases appearing during thesecond year, during the months subsequent
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
