On necrosis at the extremity of the diaphysis, and in the epiphysis of growing bones / by F.S. Eve.

  • Eve, Frederick Samuel, Sir, 1853-1916.
Date:
[1879]
Catalogue details

Licence: Public Domain Mark

Credit: On necrosis at the extremity of the diaphysis, and in the epiphysis of growing bones / by F.S. Eve. 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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    There is a similar specimen in the Hospital Museum.1 The upper part of the humerus of a child, in which the epiphysis is separated, and there is necrosis of about a quarter of an inch of the extremity of the diaphysis. The epiphysis is still connected to the shaft by one or two bands of thickened periosteum. See woodcut, Fig. 2. The sequestrum is shaded. Case II. Necrosis at the extremity of the diaphysis and in the epiphysis of the upper extremity of the tibia, causing destructive dis- ease of the knee-joint. Charles C., aged 2\ years, was admitted to Sitwell Ward, under the care of the late Mr. Callender, April 13, 1879. He had had inflammation of the knee-joint for no longer than a fortnio-ht. No cause for it could be assigned. The left knee was hot and tender, the synovial membrane pulpy and distended with fluid. The leg was in a position of extreme flexion. There was a dis- charging sinus in the upper part of the calf. The joint altogether presented the appearance of long-standing destructive disease. May 10.—Amputation through the lower third of the thigh was performed, as the child’s general condition was be- coming worse. He made a rapid re- covery. Examination of limb.—The synovial membrane of the knee-joint was pulpy ; the articular cartilage of the tibia almost completely destroyed, and that of the femur deeply absorbed in plaees. On making a section through the tibia, a piece of necrosed bone, about the size of a walnut, was found • it occupied the extremity of the diaphysis, passed across the epi- physial line, and involved a small portion of the ossific nodule in the ep^hysis. The sequestrum is shaded in the woodcut Fig 3 2 Ihe necrosis extended to the wall of the bone on the posterior surface, which was here penetrated by a small sinus. There was no communication between the cavity containing the sequestrum and the knee-joint. 1 Series I., No. 261.
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