Osteotomy and Osteoclasis for Deformities of the Lower Extremities - Tapa blanda

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. 1884 edition. Excerpt: ... case, it is generally more marked on one side than on the other. In marked cases the patella is dislocated outward, and is found riding over the external condyle, being forced into this position by the change in the axis of the tibia, or it may slip during flexion to the outside of the condyle. I have met with several cases of the deformity in adults complicated with effusion into the joint, accompanied with considerable pain. Loose bodies are found in rare cases in the cavity of the joints in those well advanced in years, but these may have had no connection with the deformity. The shape of the foot varies in knock-knee. Macewen' states that the foot is well arched, the instep high, and the patient walking principally on its outside. When the foot is nude and the patient walks, the extensor and the flexor muscles are seen to be brought well into action, and the toes seem to grasp the floor in endeavoring to maintain the equilibrium. I do no think that this statement is strictly correct. I have seen advanced cases in which the arch of the foot was flattened, although the child was walking about. And in one of the patients with genu valgum adolescentium there was marked dropping of the arch. In many, however, the condition mentioned by Macewen is found to exist. Knock-knee is often, in rachitic subjects, complicated with other curves of the long bones, as in Fig. 20, taken from a photograph of a patient at present under treatment. Mikulicz2 has recorded the result of some postmortem examinations of limbs affected with genu valgum. He found that there had been an increase of that portion of the diaphysis of the femur over the internal condyle, placing it on a lower plane than the external. Contraction of the biceps is seen in some cases of...