Excerpt from Edinburgh Medical Journal, 1891, Vol. 36: Part I
In operating upon joints in a state of acute arthritis, it is desir able to seek the true osseous lesion, which may communicate with the joint through a minute aperture in the cartilage, and not to be satisfied with scraping these secondary ulcerating patches.
So also when operating upon an acute affection of the juxta epiphysial region communicating by perforation or destruction of the epiphysial cartilage with the epiphysis, it is well to spare the cartilaginous disc as far as possible. In the laudable endeavour to make a clear sweep of diseased bone, surgeons are apt to remove the softened cartilage, and cause irreparable shortening of the limb.
The car tilaye itself, epiphysial or articular, plays but a secondary part in osteo-myelitis, though an important one. As long as the epiphysial disc is unperforated it is a line of demarcation prevent ing pus or debris from the periosteum or shaft penetrating towards the joint. If suppuration in the juxta-epiphysial region or under the periosteum passed frequently to the joint, how would the roll call of cripples be swelled?
When the neighbouring tissues are inﬂamed, the cartilage of the epiphysial disc proliferates rapidly, becomes of a yellowish tint.
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