430 Diseases of Joints. 



End of Tibia. — Lower end of a left tibia — macerated, illus- 

 trating the above. 



There has been rarefactive ostitis of the back and inner parts 

 of the lower end, and the cancellous tissue is exposed below part 

 of the articular surface. A considerable crust of new periosteal 

 bone extends up the shaft on the inner and posterior aspects. 



B. C. II. M. 58. 



7. 13. Septic Inflammation in Ankle-joint, following- Injury. 



— Lower end of a left tibia — macerated, illustrating the above. 



The patient had fallen from a great height and so alighted on the 

 ground as to injure his ankle-joint. The leg was amputated some time 

 after the accident for what was supposed to be a scrofulous affection of the 

 ankle-joint, but which has probably been suppuration owing to the septic 

 disease of the bone. 



The lower end of the tibia has evidently been split 

 vertically into an anterior and posterior portion. The latter, 

 carrying the malleolus^ is on a higher level than the former, and 

 there is a fissure between them. A portion of the original 

 articular surface remaining on the anterior fragment has evidently 

 necrosed, and has been in process of separation, for it only 

 remains attached now by a small stem on the inner side. The 

 rest of the articular surface is carious. The surface of the lower 

 end, especially at the back, is covered with irregular newly- 

 formed nodules. B. C. ii. M. 38. 



7. 14. Septic Inflammation of the Elbow, following- Com- 

 pound Fracture of the Olecranon. — Bones forming the 



left elbow of an adult — cleaned and mounted in spirit, illustrat- 

 ing the above. 



From a patient whose arm was amputated three weeks after receiv- 

 ing a compound fracture of the olecranon. 



The cartilage on the trochlear surface of the humerus is 

 almost enirely destroyed, and is represented by only a few 

 loose tagts. The cartilaginous surface of the capitellum is 

 deficient at the edge. The olecranon process is wanting, and 



