. A practical treatise on fractures and dislocations. x Medical. 1S74. 5 Adams: Lancet, 1651, vol. ii. p. 1103.^ Walshman : Quoted by Cooper, loc. p. 190. Lessen : Deutsche Chirurgie, Lief. 65, p. 131. DISLOCATIONS OF THE KNEE. 857 111 som(^ reported cases in whi(;h the dislocation has remained nnre-duced, the patient has had good use of the limb. Two such are thecases of Bagnall-Oakeley ^ and Karewski.^ The formers patient Avasa man, seventy-years old, who had dislocated his left knee at the ageof nine months; he had always made full use of the limb, and hadearned his living as a brickm
. A practical treatise on fractures and dislocations. x Medical. 1S74. 5 Adams: Lancet, 1651, vol. ii. p. 1103.^ Walshman : Quoted by Cooper, loc. p. 190. Lessen : Deutsche Chirurgie, Lief. 65, p. 131. DISLOCATIONS OF THE KNEE. 857 111 som(^ reported cases in whi(;h the dislocation has remained nnre-duced, the patient has had good use of the limb. Two such are thecases of Bagnall-Oakeley ^ and Karewski.^ The formers patient Avasa man, seventy-years old, who had dislocated his left knee at the ageof nine months; he had always made full use of the limb, and hadearned his living as a brickmaker. A false joint had formed betweenthe femur and tibia, which permitted 15 degrees of flexion. The footand leg were normally developed; the thigh had an abnormal anteriorcurvature. The patella could not be recognized, and was thought tohave become united with the femur. The different prominences of thelower end of the femur were absolutely subcntaneous and seemed readyto perforate the skin, but there was no trace of previous ulceration. Fig. Posterior dislocation of the knee. Karewskis patient was a servant girl, thirty-two years old, wliosedislocation liad existed for more than sixteen years. Tlie right limbpres(Mited a typical dislocation backward, and when viewed from In^hind looked like a genu recurvatum, while when seen i\\m\ in frontand the side the thigh overhung the leg to a certain extent. Themuscles of the calf were somewhat atrophied ; the nerves and vesselsstretched above the tibia like tense cords. The growth of the bones hadbeen mat(M-ially affected, tlu^ tibia being {\\vco eiMitimetres slu>rter than ^ Bagnall-Oakoley : Tjanrcl. ISS2. vol. i. p. .>;>. 2 Karewski: Arch, liir klin. ISStJ. vol. xxxiii. p. oJo. 858 DISLOCATIONS. the other, and also thinner; while the femur was lengthened by threeor four centimetres. The overriding of the tibia and femur was fourcentimetres. Flexion and extension were normal, both actively andpassively, and alt
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