66 



ABNORMAL CONDITIONS OF THE KNEE-JOINT. 



Same as Jig. 4, the soft parts removed, 

 1, right femur displaced forwards; 2, tiliia back- 

 wards ; 3, rough scabrous surface of tibia ; 4, 

 line of junction of the epiphysis. 



Fig. 6. 



Partial displacement 

 of femur inwards; 

 tibia and patella out- 

 wards. 



Left l.nee-joini. Displacement of femur inwards and 

 tibia outwards. 



patellae, and consequently gradually draws this 

 bone outwards completely over the outer edge 

 of the trochlea of the femur. We have seen 

 at the Richmond Hospital two similar cases of 

 this very curious result of necrosis of the tibia. 

 In these examples the knee-joint had partici- 

 pated in the inflammation of the contiguous 

 structure, and great deformity of the whole limb 

 was the consequence (jig. 7). The subject of 

 one of these cases (Christopher Tarrer, aet. 30) 

 died of erysipelas, which was idiopathic, and 

 had no connexion with the deformity. The knee- 

 joint was examined, and the patella was found 

 dislocated outwards, and anchylosed to the outer 

 surface of the external condyle of the femur 

 (Jig. 8.) The superior extremity of the tibia was 

 partially displaced backwards, and was greatly 

 deformed and enlarged, particularly the outer 

 condyle of this bone, the anterior half of which 

 was deeply excavated to receive the condyle of 

 the femur ; the posterior half of this condyle 

 was free and had no bone in contact with it; 

 but this portion of the tibia and the head of the 

 fibula were so much rotated or twisted out- 

 wards and backwards as to form a very conspi- 

 cuous elevation in the lower part of the popli- 

 teal space. The fibula was placed directly 

 behind the tibia. The lateral ligament did not 

 exist. The ligamentum patellae was greatly 



