. Diseases of bones and joints . Fig. 70. Old knee joint tuberculosis in the adult. Skiagram shows the bony union two years after a resection done according to the authors theory. Note the area of dense bone at the former siteof the joint, and the beginning canalization. break up the adhesions under ether, and then putthe joint up in plaster in an entirely different atti-tude for a couple of weeks, following this with thetreatment recommended for the milder a repetition of the operation may be ad- DISEASES OF BONES AND JOINTS 163 visable once or twice, with a changed attitude ea
. Diseases of bones and joints . Fig. 70. Old knee joint tuberculosis in the adult. Skiagram shows the bony union two years after a resection done according to the authors theory. Note the area of dense bone at the former siteof the joint, and the beginning canalization. break up the adhesions under ether, and then putthe joint up in plaster in an entirely different atti-tude for a couple of weeks, following this with thetreatment recommended for the milder a repetition of the operation may be ad- DISEASES OF BONES AND JOINTS 163 visable once or twice, with a changed attitude eachtime. For the most severe cases even these measuresmay fail, and we may be forced to consider in anadult the advisability of an Fig. 71. Same case as the preceding. Note the advancement of the processof canalization. The patient is well. BONY ANKYLOSIS. Bony ankylosis in the limbs may follow an intra-articular fracture, a pus infection, and certain ofthe chronic arthritides of Type I. I believe that itnever follows an unmixed tuberculous, gonorrheal,or typhoid arthritis. i64 DISEASES OF BONES AND JOINTS When the joint is ankylosed in a faulty attitude,we have the choice of an osteotomy and correction,or of an arthroplasty. An arthroplasty for a bonyankylosis following a mixed tuberculous infectionis probably safer than that for a fibrous one. ARTHROPLASTY. The credit of successfully making a new jointseems to belong to Helferich. Murphy has donemuch to popularize the operation in this formation of a false joint following the inter-position of muscle between the fractured ends ofa bone originated the idea. Sumita has recentlydemonstrated upon dogs the histological changes inthe joint following the
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