274 MORBID ANATOMY.
1435. A sixth specimen. Conctyles of the femur excised, with the patella, to which they are firmly anchylosecl.
The patient, set. twelve years, entered the hospital Feb. 19th, 1868 (134,188). Five years before, he received a cut near the knee with a hatchet. Considerable inflamma- tion followed, and a year afterward the joint was stiff at an angle of 45. On admission, the knee was not enlarged nor painful, but firmly anchylosed. On the 22d, the operation was performed ; the head of the tibia not being interfered with. One large and one small thin slice of bone were, however, removed from the femur, in order to bring the bones into good apposition. Holes were drilled in these last, which were sufficiently healthy, and silver-plated wires were passed through and twisted. On the 26th of April the wires were removed. On the 12th of May there was firm union, and on the 12th of June he left the hospital. 1868. Dr. H. J. Bigelow.
1436. A seventh specimen. The tibia and the posterior portion of the condyles of the femur are extensively, and for the most part deeply carious ; and there is caries of the under surface of the patella.
From a man, set. twenty-six years. Disease of two and a half years* duration. Knee bent at an angle of 40, and immovable, as well as the patella. Head of the tibia drawn back under the condyles of the femur. Very little enlarge- ment, and no external opening, but considerable pain. General health good. The operation was done Sept. 30th, 1868 ; suppuration followed, and the thigh was amputated Feb. 12th, after which the man did quite well. (Hospital, 135,258.) 1869. Dr. R. M. Hodges.
1437. Portions of the femur and tibia, from the above case after amputation. The opposing surfaces of the bones are denuded and carious, and in some parts there is a consider- able loss of substance. 1869. Dr. R. M. Hodges.
1438. An eighth specimen. From a woman, set. thirty-two years. (Hospital, 120, 138.) Disease of twelve years' duration. The leg was dislocated backward, and permanently flexed so that the toe just touched the ground when she was erect. Oct. llth, the femur was sawn through above the condyles,
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