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[Read in the Section on Surgery and Anatomy, June, 1883.]
In all chronic inflammations of the knee-joint, such as strumous synovitis, white swelling, fungus articuli, etc., there is a reflex muscular contraction, which, unless prevented or overcome by persistent extension and counter-extension during the progress of the disease, will result in more or less serious deformity, generally a partial or incomplete sub-luxation backward with outward rotation, in which position it may be anchylosed by fibrous adhesions, false anchylosis, or by bony fusion, true anchylosis.
In all cases where the disease has entirely subsided, leaving this deformity, if it is possible to separate the patella from its adhesions with the femur, and if there is any movement whatever between the tibia and the femur, it is easier to resort to brisment forcé, even if it be necessary to make subcutaneous resection of the hamstring tendons in order that the leg
SAYRE LH. AMPUTATION BELOW THE KNEE-JOINT IN PREFERENCE TO BRISMENT FORCE IN CERTAIN CASES OF DEFORMITY WITH ANCHYLOSIS. ILLUSTRATED BY TWO CASES. JAMA. 1883;I(11):325–327. doi:10.1001/jama.1883.02390110005001a
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