A Clinical Lecture on Contraction of the Knee-Joint, With False Anchylosis: Delivered at the L. I. College Hospital, Brooklyn (Classic Reprint) - Softcover

Inhaltsangabe

Excerpt from A Clinical Lecture on Contraction of the Knee-Joint, With False Anchylosis: Delivered at the L. I. College Hospital, Brooklyn

It is self-evident that first and second numbers cannot be reached by gradual extension, but demand forcible measures. With reference to the third form, it should be borne in mind that fibrous tissue, the result of plastic inflammatory exudation, is extremely dense, firm, and unyielding, possessing but a very limited amount of elasticity. It fol lows, therefore, conclusively, that the resistance of such tissue within the articular cavity cannot be overcome by gradual extension, but must be torn from its connections by sudden and forcible stretching. The dense fibrous tissue of scars is a less serious obstacle to gradual extension. The elongation thus obtained, however, is more to be ascribed to the gradual relaxation of the healthy tissues surrounding scars than to any change effected in the scars themselves. Cicatrices in the neighborhood of joints, and consequent upon joint diseases, ex tend mostly from the surface to the deeper parts, at right or acute angles; such as run across from one side of the joint to the other, are extremely rare, and if present, may materially impede the progress of treatment.

In the present state of our knowledge, it is considered doubtful whether ligamentous structures are ever subject to inflammation; if not, their elastic properties cannot be changed by any such process occurring in their neighborhood.

Nevertheless ligaments may become distorted by new formations of fibrous tissue upon them; yet they return to their proper shape and position when the obstructions are removed by extension.

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