The nature and etiology of bone disease in Kashmir ; The conservative surgery of long bones ; Necrosis of the lower jaw.

  • Neve, Ernest Frederic, 1861-
Date:
[1889?]
Catalogue details

Licence: Public Domain Mark

Credit: The nature and etiology of bone disease in Kashmir ; The conservative surgery of long bones ; Necrosis of the lower jaw. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    between the lower extremities. Cerne (of Rouen) described in 1885 at the first French Congress of Surgery the case of a boy aged 15 whose ankle joint was involved in an osteomyelitis of the tibia. After resection tho child recovered with a total shortening of 2f in.* Owen also, has recorded two interesting cases of a similar nature.f In one, a boy aged 7, the upper epiphysis of the tibia was diseased and the knee joint became implicated. The seat of disease was gouged and the knee joint drained with recovery. In the second case, a girl aged 9, there was acuto periostitis of the diaphysis of the right tibia, with sub-periosteal abscesses in all directions. Nearly the whole of the diaphysis was ne- crosed. An incision was made, and five inches of necrosed diaphysis resected. At the end of a mouth tho knee joint became affected and a sinus was discovered leading from it to tho tibial cavity. The joint was scraped and drained. Convalescence was at once established. We also have treated similar cases to these, and as I shall show afterwards with satisfactory results. And we must bear in mind what an important illustration this is of the advance of conservative surgery, for under like conditions amputation has hitherto been usually adopted. But sometimes the disease is in the course of the diaphysis. In these circumstances, it may or may not be complicated with disease of the medulla. If quite superficial and limited, there is no special advautage in interfering actively. You may do harm and remove too much. Often, however, there is profound disease of the shaft implicating the medullary cavity and causing enlargement of the bone. Cases are not uncommon in which you have a chronic suppurative osteitis with or without scattered splintery or localized central sequestra. Here, early trephining sequestrotomy, trenching and gouging of the medullary canal— all or any of these operations may come into competition with resection. And yet I venture to think that the latter will often be found to produce the most satisfactory results. There is * Diet. Encyclop, d. sc. med. Art. pdriostite, p. 227. f BHt. Med. Joum. 1837, Vol. II., p. 1385.