On the anatomy of genu valgum / by Edmund Owen.

  • Owen, Edmund, 1847-1915.
Date:
[1879]
Catalogue details

Licence: Public Domain Mark

Credit: On the anatomy of genu valgum / by Edmund Owen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    MR EDMUND OWEN. prone than the external condyle to take on inordinate growth ?” The experiments of MM. Ollier and Tripier show that artificial irritation of either femoral condyle will give rise to increased growth of that condyle; in the same way, probably, that the ivory pegs employed in the treatment of ununited fracture cause an excessive development of new hone. But these experiments do not offer a physiological explanation of the cause of the en- largement of the internal condyle in knock-kneed subjects. The means of feeding the external condyle are similar to those of feeding the internal condyle; so also with the tuberosities of the tibia. Yet one rarely observes hypertrophy of the outer masses of hone in the knee-joint and atrophy of the inner—con- ditions which would cause the salient angle of the knee to be directed outwards. The deformity of “ handy-leg ” is, in my experience, only exceptionally the result of a want of proper proportion between the articular masses of bone; the outward bowing of the knee being secondary to the curvatures assumed by the femur and tibia. In the out-patient department, at the Hospital for Sick Children, where one meets with an unfor- tunately large number of bandy-legged patients, I have found but one instance of the deformity resulting from changes in the articulation itself; this was in a girl approaching puberty. If the deflection of the tibia in genu valgum were due to excessive growth of either the internal condyle of the femur or of the internal tuberosity of the tibia, or of both these masses of bone, the pressure existing between them would be so increased that the internal lateral ligament would be rendered excessively tight. But in many rickety knock-kneed subjects a considerable amount of lateral rocking motion can be obtained in the affected joint, even when the leg is firmly extended upon the thigh. Such movement cannot be imparted to the healthy joint in the position of extension, much less could it exist in a knee whose internal lateral ligament had been rendered tense from increased intra-articular growth of bone. Given a subject whose lower extremities are too weak for the support of the weight which they are called upon to bear, either the bones will bend and possibly give rise to bandy-legs, or the ligaments will yield, and knock-knee, and probably also flat-foot, will be produced. It will be the internal lateral ligament of the knee which will give