Anchylosis after Tuberculosis of Elbow-Joint. 481 



less advanced. The bone is enlarged and roughened on its 

 surface; especially in front. The articular surface formed by 

 the lower epiphyses has for the most part disappeared. The 

 upper end of the radius is not much altered. G. C. 3465. 



c. Process of cure after tubercular disease of the elbow. 



7. 143. Tubercular Arthritis, subsiding- after involvement 



of Bone. — Bones of the right elbow-joint of a child — mace- 

 rated, to illustrate the above. 



The upper end of the ulna is greatly enlarged, while that 

 of the radius is less so. The lower portion of the shaft of both 

 bones is greatly atrophied. The lower end of the humerus is 

 enlarged, but the most noteworthy change is the absorption on 

 the inner side, so that the ulna is displaced upwards. The two 

 necrotic fragments at the lower end of the humerus are 

 apparently the remains of its lower epipliyses. The shaft of 

 the humerus is atrophied, but to a less extent than those of the 

 radius and ulna. B. C. ii. M. 50. 



7. 144. Bony Anchylosis of the Elbow after Disease.— 



Lower end of a right humerus and adjacent parts of the radius 

 and ulna — macerated, illustrating the above. 



On the front of the humerus, above the ulna, there is a 

 small cavity. This, as well as the indications of former 

 alterations of the articular surfaces, point to a healed tubercular 

 disease of the elbow. W. C. H. 45. 



d. Result of operation for tubercular disease of the elbow. 



7. 145. Excision of the Elbow for Tubercular Disease.— 



Parts remaining after excision of a right elbow — injected, and 

 in spirit, illustrating the above. 



The arm was amputated three weeks after excision owing to the 

 persistence of a profuse discharge. 



2h 



