American practice of surgery : a complete system of the science and art of surgery . at bony ankylosis after resection. Amputation.—This operation is called for only when the disease is so ex-tensive and progressive that the limb must be removed in order to save thelife of the individual. Tuberculous Disease of the Ankle Joint, Tarsus, and Metatarsus.—Tuberculous disease occurs in the ankle joint with much less frequency 12 AMERICAN PRACTICE OF SURGERY. than in the hip or knee. During adolescence and in young adults the disease ismuch more common than in children. In fact, tuberculous disease
American practice of surgery : a complete system of the science and art of surgery . at bony ankylosis after resection. Amputation.—This operation is called for only when the disease is so ex-tensive and progressive that the limb must be removed in order to save thelife of the individual. Tuberculous Disease of the Ankle Joint, Tarsus, and Metatarsus.—Tuberculous disease occurs in the ankle joint with much less frequency 12 AMERICAN PRACTICE OF SURGERY. than in the hip or knee. During adolescence and in young adults the disease ismuch more common than in children. In fact, tuberculous disease of the ankleis a comparatively rare disease in childhood. In the Hospital for Sick Children,Toronto, for example, where the patients are all fourteen years of age and under,there were only 9 cases of ankle-joint disease out of 315 cases of tubercu-lous arthritis I , about 3 per cent). Tuberculous disease of the tarsus is morecommon than that of the ankle alone. In the Childrens Hospital series thetarsus was affected twice as often as the ankle joint. It would appear that. Fig. 298.—Section through the Foot and Ankle of a Child Nine Years of Age, showing theepiphyses of the tibia, of the os calcis, and of the second metatarsal bone. The osseous arch of the footis apparent. (Original.) about a similar proportion exists at all ages, as in Cheynes series the tarsuswas affected forty times, while the ankle was involved only twenty-three Considerations.—For our purpose here only brief reference needbe made to certain of the anatomical features of the ankle and foot. Movementat the ankle joint is restricted almost solely to dorsal and plantar flexion. Thereis a slight amount of lateral movement possible when the joint is in a positionmidway between extreme dorsi-flexion and extreme plantar flexion. Thelateral movement is permitted while the foot is in the attitude mentionedbecause while in that position the widest part of the astragalus has passedfrom betw
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