A treatise on orthopedic surgery . ss 25 13 3 8 15 4 0 17 5 5 19 6 4 21 7 8 23 8 1 25 9 2 29 10 5 11 1 1 Total 59 Males, 28; females, 31; right, 27; left, 32. ^ Festschrift fiir Billroth, 1892. ^ Karewski, Chir. Krank. des Kindersalters, p. 268. ^ Deutsche Zeits. f. Chir., Bd. xxvii. * Archiv f. klin. Chir., Bd. xxxiii. ° Koenig, Lehrbuch Spec. Chir., Berlin, 1900. Sever reports 50 cases ina total of 7,474 cases of spine and joint tuberculosis treated at the BostonChildrens Hospital. Bost. Med. and Surg. J., May 19, 1910. 486 OBTHOPEDIC SUEGEBY. Symptoms.—The symptoms are those of a chronic, p
A treatise on orthopedic surgery . ss 25 13 3 8 15 4 0 17 5 5 19 6 4 21 7 8 23 8 1 25 9 2 29 10 5 11 1 1 Total 59 Males, 28; females, 31; right, 27; left, 32. ^ Festschrift fiir Billroth, 1892. ^ Karewski, Chir. Krank. des Kindersalters, p. 268. ^ Deutsche Zeits. f. Chir., Bd. xxvii. * Archiv f. klin. Chir., Bd. xxxiii. ° Koenig, Lehrbuch Spec. Chir., Berlin, 1900. Sever reports 50 cases ina total of 7,474 cases of spine and joint tuberculosis treated at the BostonChildrens Hospital. Bost. Med. and Surg. J., May 19, 1910. 486 OBTHOPEDIC SUEGEBY. Symptoms.—The symptoms are those of a chronic, persistent,destructive disease—jxiin^ local sensitiveness and swelling, stiff-ness, deformity, atrophy. The pain is usually localized at the elbow. It is increased bysudden movements, and as the bones are so superficial there isusually local sensitiveness to pressure, most marked over the seatof the disease. In the early stage the swelling is slight, and itis of the peculiar elastic character due to thickening of the Fig. Tuberculous disease of the elbow-joint. tissue rather than to effusion within the capsule, but as thedisease progresses the joint assumes the peculiar spindle shapecharacteristic of white swelling. The degree of elevation of thelocal temperature depends upon the activity of the disease. Themost important physical sign is the restriction of motion due tothe characteristic muscular spasm which becomes evident whenthe limit of painless motion is passed. The limitation of ex-tension and flexion gradually increases, and finally the limb be-comes fixed in an attitude midwav between flexion and exten- DISEASES OF ARTICULATIONS OF UPFEB EXTEEMITTAS7 sion, with the forearm in an attitude between pronation andsupination. This is the characteristic deformity of the of the muscles of the arm and forearm is present,corresponding to the intensity and duration of the disease andto the functional disability of the joint. Fig. 322.
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