Second memoir on excision of the knee-joint : to which is appended a remarkable example of the power of operative surgery in saving the same articulation / by Richard G.H. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: Second memoir on excision of the knee-joint : to which is appended a remarkable example of the power of operative surgery in saving the same articulation / by Richard G.H. Butcher. Source: Wellcome Collection.

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    be thought of by some surgeons, I am satisfied that a firm joint might be easily obtained by removal of an inch and a half of the tibia.” If now requisite, and so likely to be productive of permanent benefit, how much more so, when the part was not so extensively diseased, and when the removal of it would have incurred no additional danger, no new and serious operation, such as opening up the extensive articulation again? But let it likewise be remembered, that some importance must be attached to the quantity of bone removed in reference to use¬ fulness of the limb in progression. It is stated that “ about two inches of the end of the femur were removed.” A thin slice removed from the articulating end of the tibia, at first, would in all likelihood be enough, while now, when the disease has pro¬ gressed, it is supposed that “ an inch and a half” would be re¬ quired : and yet he expresses even a doubt of this quantity being sufficient, in the words, “although amputation might be thought of by some surgeons.” The case No. xvn., successfully operated on by Mr. Fer- gusson, February 2, 1856, is most remarkable:—“ On May 2, discharged cured; the sinuses are nearly all healed up; the knee is stiff and straight, and the patient is able to bear his weight upon it when walking, thirteen weeks after the opera¬ tion.” “ On May 31, the patient came to show himself; he is able to walk without crutches, having the sole of his boot a little thickened.” Mr. Jones, of Jersey, in writing to me re¬ cently, alludes to this case thus:—“ I saw one of Fergusson’s cases, a most splendid specimen; the youth walking about almost as if nothing had happened.” Cases No. xvm. and xxx., successfully operated on by Mr. Erichsen, the former on February 6, 1856^ and the latter on July 2, 1856, made most rapid recoveries. In the first instance, “the man was walking about the ward on crutches within three months, his general health greatly improved, and con¬ tented and cheerful.” In the second, “ the boy had not one bad symptom, and on September 3, nine weeks after the ope¬ ration, he was going about the ward on crutches. The joint was firmly anchylosed, and the wounds healed; his recovery is perfeot.” In reference to both these cases I have been favoured with the following note from Professor Erichsen:— “ Welheck-street., December 1, 1856. “ My dear Sir,—I have much pleasure in giving you the information you require: both patients are now perfectly well; they walk easily with the aid of a high-heeled shoe, and, in fact, have very useful limbs. I have had no case of excision