One must acknowledge that the mechanics of the silk ligament as advocated by Lange is a distinct contribution to paralytic surgery. So practical and rational seemed the introduction of the artificial ligament, so encouraging the production of new periosteal tissue engrafted along the silk, that orthopedists generally have utilized the procedure with varying permanent success.
This brief paper simply reviews my personal experiences with the silk ligament.
Since the introduction of Lange's silk ligament, I have utilized it in forty-eight selected cases, modifying my technic from time to time as improvements have been suggested. I have used it most frequently in the region of the ankle, but my range includes its use in two pathologic defects of the shoulder
EDWARD A. RICH. LIMITATIONS OF LANGE'S SILK LIGAMENTS IN PARALYTIC SURGERY AND SUBSTITUTES THEREFOR. JAMA. 1913;61(18):1597–1598. doi:10.1001/jama.1913.04350190015004