The treatment of white swelling of the knee / by A.B. Judson.

  • Judson, Adoniram Brown, 1837-1916.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: The treatment of white swelling of the knee / by A.B. Judson. 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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    throws a harmful strain on the ligaments. If straight, the weight is borne by a linear column of bone. Even if the posterior subluxation of the tibia on the femur* is not en- tirely reduced, allowing the axis of the tibia, when the limb is fully extended, to lie a trifle behind that of the femur, the supporting power of the entire column is not seriously im- paired. And, when the patient is freed from treatment and walks with a stiff knee, the gait is susceptible of great im- provement by an extremely simple and inexpensive device. It will be evident on observation that the chief defect in walking with a stiff knee arises from an elevation of the pelvis on the affected side at every step, in order that the foot may be slightly raised from the ground as the limb swings forward. Ordinarily the foot clears the ground as it swings forward by a slight flexion of the knee. If, how- ever, the knee is stiff, the same effect may be produced bv removing the heel of the shoe and increasing the height of the heel of the well side. This will, of course, necessitate a greater degree of flexion in the well knee when that limb swings forward in its turn, but this compensation is not attended with inconvenience, and is always made uncon- sciously whenever we strike a sidewalk which is consider- ably inclined from side to side. When we have, by the means above described, relieved pain, reduced the deformity, protected the joint from mo- tion and violence, and equipped the patient for active loco- motion, we have given our patient wlmt I conceive to be the greatest benefit which the present state of our science per- mits in cases of this kind. We have, of course, fallen short of what is done for the relief of many other surgical dis- * Subluxation is clearly the result chiefly of enlargement of the lower extremity of the femur, another result of which is seen in the lengthening of the affected limb. Contraction of the extensors and the presence of the lateral ligaments are secondary causes of this deformity.
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