. The diseases of children : medical and surgical. be laterally. Wehave seen a case of separation of the lower epi-physis of the tibia in a boy of about ten years whowas under the care of our colleague Mr. case was complicated by the presence of aupwards from the epiphysial line. The foot andlower fragment were displaced outwards, and the deformity could not bereduced until some weeks after the accident, when the ends of the bonewere exposed by operation and with some difficulty replaced. We havealso met with an instance of compound separation of the lower epiphysis ofthe fibula. Th
. The diseases of children : medical and surgical. be laterally. Wehave seen a case of separation of the lower epi-physis of the tibia in a boy of about ten years whowas under the care of our colleague Mr. case was complicated by the presence of aupwards from the epiphysial line. The foot andlower fragment were displaced outwards, and the deformity could not bereduced until some weeks after the accident, when the ends of the bonewere exposed by operation and with some difficulty replaced. We havealso met with an instance of compound separation of the lower epiphysis ofthe fibula. The lower fragment became necrosed and was removed. The diagnosis of epiphysial separations need not be further describedhere : the locality, age of the patient, and the symptoms mentioned usuallymake the case clear, and any injury in the neighbourhood of a joint ofdoubt- 1 Vide R. W. Smith on Fractures and Dislocations. 2 Brit. Med. Jour. May 24, 1884. ^ Mayo Robson, Anttals of Surgery, 1893, vol. xviii. ; Tubby, Antials of Surgery,1894, vol. Fig. 212. —Separation of lowerepiphysis of left femur. Theepiphysis is displaced for-wards, and the knee isflexed. vertical fracture running
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