American practice of surgery : a complete system of the science and art of surgery . is, with local periostitis develop-ing over the inner surface of the tibiae of both legs. These patches usually developedas a result of some slight trauma. On each of these occasions the necrosed bonewas removed by an operation performed with the aid of cocaine anaesthesia, andin each instance the subsequent healing took place slowly. The intervals betweenthese attacks sometimes lasted for several months. Her general condition hadgreatly improved. The case is of some interest as illustrating the marked persist
American practice of surgery : a complete system of the science and art of surgery . is, with local periostitis develop-ing over the inner surface of the tibiae of both legs. These patches usually developedas a result of some slight trauma. On each of these occasions the necrosed bonewas removed by an operation performed with the aid of cocaine anaesthesia, andin each instance the subsequent healing took place slowly. The intervals betweenthese attacks sometimes lasted for several months. Her general condition hadgreatly improved. The case is of some interest as illustrating the marked persistence of thedisease, its confinement to both tibiae (with the exception of the enlargementof the distal end of the radius, which, however, gave her no pain or inconvenience),and the resistance of the bony disease to antisyphilitic treatment. The con-genital deformity of the left forearm and hand; the satisfactory result ob-tained after extensive operation upon the right tibia, including resection ofan inch and a half of its shaft; and the firm union of the divided ends oi the bone. 384 AMERICAN PRACTICE OF SURGERY. —notwithstanding the suppurative process and the extensive disease of thebone—arc also points worthy of note. S^ iHiLiTic Dactylitis. 1 );iriylitis is one of the numerous phases by which cither tertiary or heredi-tary syphilis may manifest itself. It consists of a gummatous inflammationof the fingers or toes, the ringers being more frequently affected than the toes. It may begin in the connective tissue or ligaments surrounding the joint, in the periosteum, or in the bone itself. When Dr. R. W. Taylor wrote the first important paper on this subject, in 1871, only five cases had been recorded. Since that time, as a result of more careful observation, a number of other cases have been reported; con- Fig. 173.—Hereditary Dactylitis sequently. this affection is no longer con- Syphilitica. (Erich Lexer: Lehrbuch si(lere(l ^ ; ,1(AV Jls formerly. It does <lcr
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