On excision of the knee-joint / by R.J. Mackenzie.

  • Mackenzie, Richard James, 1821-1854.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: On excision of the knee-joint / by R.J. Mackenzie. 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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    of ]Mi’ Filkin’s case exists. Mr Park, in speaking of the result of his first case, says that a year after the operation liis patient “ was able to walk with great ease and firmness, without even the assist- ance of a stick, or of any kind of S})lint to support the union,” “the foot being three quarters of an inch shorter than the other one.” Seven years later Mr Park gives this additional account of the same case :—“ To the history of the case of Hector M‘Caghen, I have now to add, that he afterwards made several voyages to sea, in which he was able to go aloft with considerable agility, and to per- form all the duties of a seaman ; that he was twice shipwrecked, and suffered great hardships, without feeling any further complaint in that limb ; but was at last unfortunately drowned by the upsetting of a flat in the river Mersey.” IMr Park repeated the operation, but his second case proved less fortunate, the patient, a very unfavour- able subject for the operation, having died about four months after its perfonnance. Moreau, some time afterwards performed the operation in three cases. Of his first case he says :—“At the end of the third month the consolidation of the bones was such that I left the limb at liberty in bed ; the patient moved it about at his pleasure ; in short, I flat- tered myself that I should be able to make him walk upon crutches in a month or six weeks ; but an event, with which my operation liad nothing to do, deprived me of that satisfaction. Epidemic dy- senteiy of a fatal kind appeared in the hospital, by which the patient was attacked, and from which he sank three months and a half after the operation. “ This unfortunate accident,” says Moreau, “ deprived 'me of the pleasure of enjoying the fruits of my cai’e; but I remain convinced of the utility of the operation, and persuaded of the pro- priety and necessity of performing it in similar cases. I looked on my patient as cured, for I had no relapse to dread.” In Moreau’s second case the operation proved fatal. In a third case by the younger Moreau, the result was more fortunate, the patient recover- ing with a serviceable limb. In 1809, Mulder excised the knee-joint of a pregnant female. Two months after the operation she \vas delivered of twins, and some time afterwards died from tetanus. The next notice of the operation is by Mr Crampton, in 1823. The operation in Mr Crampton’s first case can scarcely be said to bear on the question of excision of the knee-joint; not only were the patella and part of the tibia removed, but upwards of six inches of the thigh boire were taken away. The patient, however, lived upwards of three years after the operation, and then died from phthisis. Mr Crampton, in his remarks on the case, says, that it “ was one to which the operation of excision was not applicable.” The disease had proceeded too far ; for, even had it been possible to have removed the whole of the diseased bone, and that union had taken place between the femur and tibia, the lim ness, would have been useless. The operation was b, from its short- performed in the