A treatise on orthopedic surgery . joint in which move-ment causes pain. Lorenz states that he has treated cases satisfactorily by in-ducing anterior transposition of the head of the femur andfixing the limb for a time in an attitude of extension and ab-duction. In many instances neither the operative nor the bracetreatment is feasible, but the use of a firm flannel spica bandageor similar support, combined with the application of cautery,from time to time, adds to the comfort of the patient. CHAPTEE IX. TUBERCULOUS DISEASE OF THE KNEE-JOINT. Synonyms.—White swelling, tumor albus. Tuberculous
A treatise on orthopedic surgery . joint in which move-ment causes pain. Lorenz states that he has treated cases satisfactorily by in-ducing anterior transposition of the head of the femur andfixing the limb for a time in an attitude of extension and ab-duction. In many instances neither the operative nor the bracetreatment is feasible, but the use of a firm flannel spica bandageor similar support, combined with the application of cautery,from time to time, adds to the comfort of the patient. CHAPTEE IX. TUBERCULOUS DISEASE OF THE KNEE-JOINT. Synonyms.—White swelling, tumor albus. Tuberculous disease of the knee-joint is next in frequency andimportance to that of the hip. It is, however, far less dangerousto life, and the prognosis, as regards function, is much betterthan in the former affection. This is accounted for by thesimplicity of the joint and by its situation at a distance from thetrunk, at the junction of two levers of nearly equal length andsize. As the problem of protection by mechanical means is com- :1. Fig. 288. Section of knee-joint at the age of eight years,showing the epiphyses of the femur and tibia andtheir relation to the capsule. (Krause.) Thecentres of ossification in the epiphyses of thefemur and tibia are present at birth. Ossificationis completed in each at about the twentieth year. The range of motion is from slightly more thancomplete extension to about 50 to 60 degrees. Incomplete extension the tibia is rotated outward onthe femur. In midflexion the laxity of the liga-ments permits a range of inward and outward ro-tation of about 25 degrees. paratively simple it is more often applied, and in proportion toits efficiency the injury is lessened and the tendency to deformityis checked. Pathology.—The disease may begin in the epiphysis of thefemur or in that of the tibia, occasionally in the patella or in thehead of the fibula, or primarily in the synovial membrane. In 547 cases,^ about two-thirds of which were in adults,treated at Koenig
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