272 MORBID ANATOMY.
ter years after excision of the knee-joint. (See last speci- men.)
Dec. 13th, 1861, the man again entered the hospital (96, 138), with a fracture of the left thigh, and died on the 16th. A long, section having been made, there is seen to be a con- tinuous and healthy cancellated structure between the bones ; anteriorly, the surfaces are continuous, though with slight flexion, but posteriorly the head of the tibia projects about three-fourths of an inch backward. The half of the patella that remained after the excision has been attached to the board, upon which the other is displayed, and is the smallest and least compact of the two. 1862.
Dr. H. J. Bigelow.
1431. A second specimen of excision of the knee-joint. The condyles are shown, to the outer of which the patella is an- chylosed, and upon the cancellated surface of which a de- fined cavity is seen ; this last, which was cut through in the operation, is about 1 in. in diameter, and the surround- ing bone appears healthy. One large and two small slices from the tibia are also shown, the articular surfaces of which are irregular, but scarcely carious.
The patient was a woman, set. twenty-four j^ears. (Hos- pital, 123, 126.) When. four years old she struck her knee, and was laid up for a year ; but afterward used the limb freely till the age of eighteen, though with occasional pain and swelling. She then became worse and used crutches for three years, with formation of abscesses. The limb was nearly straight, but with the condyles upon the anterior edge of the head of the tibia. Motion very slight. No pain ; and no discharge for the last year. Operation Nov. 10th ; silver wire passed through the bones and twisted ; and a straight splint applied. Profuse discharge followed, with fever and chills, and the patent died on the eighteenth day. 1866. Dr. H. J. Bigelow.
1432. A third specimen. Condyles of the femur removed. From a little boy five years of age. (Hospital, 123, 128.) Disease since he was seven months old. Knee bent per- manently to a right angle ; swollen and inflamed. Opera- tion Nov. 18th, a small piece of the tibia also removed ;
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