Osteotomy, with an Inquiry Into the Aetiology and Pathology of Knock-Knee, Bow-Leg, and Other Osseous Deformities of the Lower Limbs - William Macewen

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1880 edition. Excerpt: ... children, and one can understand that the osteoclast manuelle might be practicable in the stage of ramollisement, while the bones are soft and would be more apt to yield than the ligaments. On one occasion this method was practised by me on a boy aged five years, and after much difficulty the limbs were rendered tolerably straight, by what appeared to be a separation of the femoral epiphysis. The difficulty of effecting this was much greater than the performance of osteotomy, and the result was not so good as that obtainable from osteotomy of the femoral diaphysis. M. Delore fixes the age of eighteen years as the limit within which the method can be practised, but this is considered very much beyond the age at which the method can be practised with safety, as it must be very difficult and even hazardous to attempt it after eburnation has set in. Volkmann tried to do so in one instance and failed. On two occasions I attempted to straighten the limbs of persons about twelve years of age by osteoclasie manuelle and failed. It is true, however, that the united force of a number of assistants was not employed. While favourable results are obtained in the child, the practice of the method in the adolescent presents quite another aspect. Out of 26 limbs--13 operated on by, Billroth, 1 by Guerin, and 12 related in the Thesis of Saurel, Barbarin, De Santi, Vergues, and Aysaguer--8 were perfectly rectified, 7 incompletely so, 2 were followed by subacute arthritis, and 9 had lateral movements to such a degree as to render walking very difficult. What is the lesion which ensues in osteoclasie manuelle as applied to knock-knee? This question has been investigated by MM. Saurel, Barbarin, and Barbier, who practised this method post-mortem, on the..