On ankylosis, or stiff-joint : a practical treatise on the contractions and deformities resulting from diseases of joints / by W.J. Little.

Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: On ankylosis, or stiff-joint : a practical treatise on the contractions and deformities resulting from diseases of joints / by W.J. Little. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    ON ANKYLOSIS. tration of lymph has yet to be absorbed, some thickening of the tissues exists, the ligaments have not re-acquired their extensibility, the muscles have adapted themselves to the shortened state of the condition of repose of the limb; and whenever the practitioner attempts to straighten the limb, or the patient summons resolution spontaneously to effect the same, the painful tenderness of the joint which is immediately experienced, or the sensation of stiffness behind and around the articulation, together with the feeling of its powerless condition, too often occasion procrastination of this important part of the cure — the restoration of the natural form and movements of the limb. If the judicious management of the practitioner be seconded by proper perseverance on the part of the patient, the case proceeds favourably, motion is gra- dually perceived, the extent of which is daily augmented by passive and active exercises, the tenderness experienced on first attempting to move the articular surfaces subsides, and the patient completely recovers. But let us reverse the case, and suppose the fear of reproducing inflammation by passive movements of the limb, the want of the necessary resolution to persevere in the use of troublesome restorative measures— frictions and manipulations; or that the inflammation of the joint having been very acute or of long duration, and the patient's health, or even his life, having been endangered by constitutional disturbance, the friends and the patient feel too happy in having escaped imminent peril, and abandon the limb for a time as a thing of inferior importance,—what are the further changes which ensue ? These are usually more serious if the subject be young, and the growth of the frame be still in progress. I have ah-eady stated that the advance of deformity proceeds rapidly on the destruction of the equilibrium in different classes of muscles; and the tend- ency to retraction in their fibres may not be arrested until the member becomes contracted to the full extent of the movements natural to the part, and sometimes the contraction proceeds to a greater extent.
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