Saint Bartholomew's Hospital reports . lower end of the tibia was removed by great improvement apparently taking place, amputationthrough the leg was performed three months later under the im-pression that there was destructive disease of the ankle-joint. Examination.—On making a sec-tion through the lower end of thetibia and ankle-joint, a cavity largeenough to contain a walnut was foundin the lower end of the tibia com-pletely filled np with gelatinous granu-lation tissue, but still communicatingwith the surface by the sinus above theinternal maleolus. The cavity, as inthe prece
Saint Bartholomew's Hospital reports . lower end of the tibia was removed by great improvement apparently taking place, amputationthrough the leg was performed three months later under the im-pression that there was destructive disease of the ankle-joint. Examination.—On making a sec-tion through the lower end of thetibia and ankle-joint, a cavity largeenough to contain a walnut was foundin the lower end of the tibia com-pletely filled np with gelatinous granu-lation tissue, but still communicatingwith the surface by the sinus above theinternal maleolus. The cavity, as inthe preceding specimen, occupied theepiphysis and extremity of the dia-physis (Fig. 4).^ The upper portion of the articularsurface of the tibia was united to theastragalus by a layer of fibrous cartilages were otherwise intact,but slightly thinned at the joiut did not contain an excessof fluid. Apart from the situation of thedisease, the case is interesting from the repair which has followedthe removal of the Fig. 4- ^ The apecimen is preserved in the Museum, Series I., No. 394. And in the Fpiphijsis of Groioing Bones. 133 Case IV. A precisely simiLar specimen was removed by amputation froma man aged 37, who was lately admitted to the Hospital forcaries of the lower end of the tibia. When a boy he had diseasein the same situation attended with the discharge of small piecesof bone. The part had remaiued sound until three weeks beforehis admission/ when the same general appearances were pre-sented as in the preceding case. Case V. Circumscribed necrosis at the extremity of the diaphysis of femur—Disease of Jmee-joint—Unsuccessful resection. The specimen was removed by amputation from Edith J.,aged 4 years. Thirteen months before the right knee-joint wasexcised in the country for disease of i J years duration. On heradmission to Stanley Ward the knee was flexed to a right angle,and there was a discharging sinus at the inner angle of the opera-tion sc
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