American practice of surgery : a complete system of the science and art of surgery . foot at the instep in the child and in the adult. The bones of the foot and ankle are made up of cancellous tissue, with buta very thin covering of compact tissue (vide Figs. 298 and 299). The articularsurface of each bone, too, is seen to be provided with quite a thick layer of 14 AMERICAN PRACTICE OF SURGERY. articular cartilage. Lastly, attention should be directed to the epiphyseal carti-lages. Those at the ankle are shown in section in Fig. 300. It will be observedthat the epiphysis of the fibula is place
American practice of surgery : a complete system of the science and art of surgery . foot at the instep in the child and in the adult. The bones of the foot and ankle are made up of cancellous tissue, with buta very thin covering of compact tissue (vide Figs. 298 and 299). The articularsurface of each bone, too, is seen to be provided with quite a thick layer of 14 AMERICAN PRACTICE OF SURGERY. articular cartilage. Lastly, attention should be directed to the epiphyseal carti-lages. Those at the ankle are shown in section in Fig. 300. It will be observedthat the epiphysis of the fibula is placed lower than that of the tibia, and thatthe epiphyseal disc of cartilage of the fibula is exactly on a level with the supe-rior articular surface of the astragalus. The epiphysis of the os calcis is seen inFig. 29S. It exists upon its posterior extremity. Etiology and Pathology.—The same etiological factors are at work here aselsewhere, in the production of tuberculous arthritis, and they have alreadybeen fully discussed. In the ankle, however, chronic sprain is a more frequent. Fig. 300.—Sections through the Ankle Joint of a Child Xine Years of Age, Showing the EpiphysealCartilages of the Tibia and Fibula. (Original.) cause of tuberculous disease than is the case in the other joints. For this reasonone should always look upon a sprained ankle as serious, particular) in an in-dividual predisposed to tuberculous disease. The disease is said to be more frequently primary in the synovial membranewhen the ankle joint is affected, and as a rule primary in bone when the tarsusis the seat of disease. Fig. 248 (p. 577) is a good illustration of a sequestrum inthe anterior part of the astragalus in an old case of tuberculous disease; the con-dition of sclerosis of the bone forming the walls of the cavity in which the se-questrum lies is worthy of note. Fig. 301 is a photograph of a frozen sectionthrough the foot of a lad seventeen years of age, who ten years previously hadhad his ri
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
