A study of the anatomy and the clinical importance of the sacro-iliac joint / Fred H. Albee.

  • Albee, Fred H. (Fred Houdlett), 1876-1945.
Date:
1909
Catalogue details

Licence: In copyright

Credit: A study of the anatomy and the clinical importance of the sacro-iliac joint / Fred H. Albee. 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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    Oil account ol* the abovc-meiitionecl disagreement of the best authorities as to the anatomy of this joint, with emphasis on tlie term ‘‘joint’^ rather than syn- chondrosis, 1 was induced to ascertain, if possible, by the dissection of a sufficient number of joints, its true anatomy. l>y the kindness of Professor Haynes an abundance of material was furnislied me at the Cornell University 'Medical College. '^^riie results of this work are briefly as follows: In the careful dissection of fifty specimens a perfect joint, composed of all its elements, such as synovial membrane and cavity, and strong well-formed capsule was found in each instance, and proved to be as constant in its size and relations as any other joint. r>efore opening the joints many were injected with an ac|ueous solution of inetliylene blue, wliicli colored the synovial membrane so that it could he seen to distend and retract all along the anterior-inferior aspect of the joint when motion was elicited. This part of the capsule is very thin, which accounts for the fact that infection of this joint is very j)rone to discharge by this avenue into the ])elvis and rarely through the very thick part of the capsule posteriorly; also, this part of the capsule often ruptures in symphysiotomy, and in case of puerperal sepsis opens the joint to infection. Sansten states that it ruptures in 44 per cent, of cadavers below (5 c.c. of pubic separ- ation. The lumbosacral cord passes in close proximity to the joint at its lower third, and undoubtedly is fre- rpiently involved in affections of this joint, thus explain- ing the presence of persistent pain in the distribution of this nerve, i. e., sciatica. The articulation is easily opened by incising the anterior part of the capsule and forcing the pelvic bones apart in front, the symphysis pubis having already been separated. The sacrum and the ilium swing on the posterior and interosseous ligaments, as a door on its hinges. Hence the frequent interference with locomo- tion and permanent injury of this joint following sym- physiotomy. In my dissections the interosseous ligament always separated from the ilium and never from the sacrum. The round ligament sometimes ruptured and sometimes its bony attachment. The anterior or auricular portion of each articular surface was covered with a thin plate of cartilage, which was thicker on the sacrum than on the ilium. It averaged, in the fifty specimens, in its