File:American practice of surgery - a complete system of the science and art of surgery (1906) (14782463785).jpg

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
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Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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of age.The greater part of the carpus was cartilaginous; ossification had appeared only in two bones of thecarpus, namely, the os magnum and the unciform, and in the lower epiphysis of the radius. The x-ray picture showed tuberculous invasion of these two carpal bones and of the proximal extremities of thesecond and third metacarpal bones. The characteristic appearances are at once appreciated by com-paring the radiograph of the diseased wrist (Fig. 1) with that of the sound side (Fig. 2). The patienthad exhibited signs of tuberculous affection of the right wrist for three months previous to the makingof the x-ray picture. An operation was performed, and the accuracy of the conclusions arrived atfrom a study of the radiograph was confirmed. The x-ray picture was reproduced by Dr. S. Cummings. of Toronto, under whose care the patientwas treated and to whom the author is indebted both for the photographs and for the history of thecasi AMERICAN PRACTICE OF SURGERY PLATE XXVII Fig. i Fig.
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RADIOGRAPHS ILLUSTRATING TUBERCULOUS DISEASE OF THEWRIST-JOINT IN A CHILD TWO YEARS OF AGE TUBERCULOUS DISEASE OF BONES AND JOINTS. 655 of the joint, as is happily the case in some instances, but, by appropriate means,deformity may be prevented, and, if a stiff joint results, the limb is fixed in aposition which will subsequently be of most service to the patient. Shorten-ing is inevitable if there is destruction of bone; flexion and adduction may,however, be corrected or prevented by appropriate mechanical apparatus. Ifthe disease comes under observation at an early stage, then it will be neces-sary to maintain treatment for at least two or three years before a cure can beassured, even where satisfactory progress is made. A slight degree of flexion may not cause much disability, but, when itamounts to more than thirty degrees, the impairment of function is marked.In extreme cases the joint may be fixed with flexion amounting to ninety de-grees, and then much discomfort and disability

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