both bones carious to a small extent, with an abscess in the popliteal space. Did well for a time, but afterwards lingered with suppuration and diarrhoea, and died May 30th. 1866. Dr. H. J. Bigelow.
1433. A fourth specimen. Section of the tibia about two-thirds of an inch thick, and a portion of each condyle of the femur. Surfaces carious with eburnation.
From a man, thirty-two years of age. (Hospital, 78, 156, and Med. Jour. Vol. LIX. p. 284.) Disease of the joint of about four and a half years' duration. Recovery rapid ; and in about five months there seemed to be a bony union. 1859. Dr. J. M. Warren.
1434. A fifth specimen. Excision of about 2 in. of the lower end of the femur.
The patient (Hospital, 115, 62) was fifteen years of age, and sprained his knee when he was three years old. Four years afterward he had acute inflammation of the joint, and from that time had been unable to walk upon the limb. The knee was fixed at an angle of 110, painful and sensi- tive on pressure, considerably enlarged and distorted, and with an open sinus upon the inside of the leg. The general health being good, excision was performed May 21st, 1864. A transverse incision was made, and carried well down upon the sides for the escape of the pus that might subse- quently form. The bone was then removed with the patella, which was consolidated with it, and also a small portion from the tibia; the caries being rather deep, though limited. Considerable force was required to break down the false anchylosis that existed. Hamstring muscles di- vided. Diseased synovial membrane cut away with the scissors. The rigidity of the nerve and vessels in the popliteal space rendered the straightening of the limb con- siderably difficult, even after the removal of the bone. Dur- ing the first forty-eight hours there was a strong tendency to displacement, which was overcome by straps and firm compression ; but four weeks after the operation, there was some stiffening of the bones, suppuration had diminished, and after a very long convalescence, he was discharged well, June 14th. 1865. Dr. E. M. Hodges.
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