Injuries and diseases of the knee-joint : considered from the clinical aspect / by William Bennett.

  • Bennett, William H. (William Henry), Sir, 1852-1931.
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: Injuries and diseases of the knee-joint : considered from the clinical aspect / by William Bennett. Source: Wellcome Collection.

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    violent injury, although, naturally, as a rule,, the gravest results follow the severest injuries. In young males, if the extravasation into the joint follows a trivial injury, the possibility of the exis¬ tence of haemophilia must not be lost sight of. Heavy blows, it should be remembered, are apt to cause much bruising and extravasation around the joint; the effusion into the joint itself may be com¬ paratively small and perhaps synovial only. The pain is at first frequently less marked in cases in which the injury has been most severe, especially if it be a blow, in consequence of the parts being numbed by “ shock ”; the reactionary pain, however, is then greater. As the distension reaches its full degree the limb assumes a position midway between exten¬ sion and semi-flexion, because the capacity of the articulation is greatest in that position. In every case of this kind the possibility of fracture must, of course, be borne in mind, although the gross signs of it may be absent. Manipulation may be too painful to admit of any adequate examination without an anaesthetic; moreover, in any case the unnecessary manipulation of a bleeding joint is to be avoided, hence the N rays, when available, should always be employed. The existence of fracture or dislocation having been eliminated, the question of treatment arises. In the absence of fracture, fixation by splints is unneces¬ sary as well as uncomfortable; the limb merely