American practice of surgery : a complete system of the science and art of surgery . of the acetab-ulum is largely cartilaginous. After the first year of life, however, the ossi-fied epiphyses become more numerous in the skeleton and we then have to dowith the epiphyseal disc of cartilage which persists for a variable period be-tween the diaphysis ami the epiphysis. These facts are shown very clearly ifone compares a section through the foot and ankle of an adult with that throughthe foot and ankle of a child (compare Fig. 298 with Fig. 299); or sectionsthrough the knee-joint at these differen
American practice of surgery : a complete system of the science and art of surgery . of the acetab-ulum is largely cartilaginous. After the first year of life, however, the ossi-fied epiphyses become more numerous in the skeleton and we then have to dowith the epiphyseal disc of cartilage which persists for a variable period be-tween the diaphysis ami the epiphysis. These facts are shown very clearly ifone compares a section through the foot and ankle of an adult with that throughthe foot and ankle of a child (compare Fig. 298 with Fig. 299); or sectionsthrough the knee-joint at these different ages | vide Fig. 2x7 and Fig. 288). Wewould therefore insist upon the importance of recognizing the anatomical dif- TUBERCULOUS DISEASE OF BOXES AND JOINTS 5G1 ferences which exist in the joint structure of a child as compared with that ofthe adult—the cartilaginous extremity of a long bone in infancy, later the ossi-fied epiphysis with the persistence of the epiphyseal disc, and finally the adultstructure, where all trace of the epiphysis as an individual structure has dis-. Fig. 247.—Frozen Section through the Body of a Child One Year Old. The hip, shoulder, elbow,and sacro-iliac joints are shown in the section. (Original.) appeared as the result of its union with the diaphysis. The fact that the growthin length of a long bone is dependent upon the existence of the epiphyseal discof cartilage was long ago demonstrated by John Hunter in the ingenious ex-periments which were carried on by him on the bones of growing animals. Thetruth of this fact is every day illustrated by experience; if the epiphyseal carti-vol. in.—36 562 AMERICAN PRACTICE OF SURGERY. lage is destroyed, by injury, disease, or by operation upon a joint, then thebone ceases to grow in length at that point. It may be noted here that dif-ferent kinds of epiphyses are recognized in the human skeleton. There are threevarieties: First, those to which we have already alluded, separating the ar-ticular extrem
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