Two cases of rupture of the crucial ligament of the knee-joint / by James Stark.

  • Stark, James, 1814-1883.
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of rupture of the crucial ligament of the knee-joint / by James Stark. 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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    Crucial Ligament of the Knee-Joint. vature, was therefore softly padded and bound to the back of the knee-joint, half of its length projecting down the back of the leg, half extending along the back of the thigh. The foot and leg, to above the knee, were then bandaged moderately tight, merely with the view of preventing any stoppage to the circulation from the pressure at the knee; and the patient, after a week’s confine- ment to bed, was allowed to trail about the house on crutches. At the end of a week from the date of the injury, the heavy wearied feeling in the knee had increased, and slight uneasiness was experienced on pressing into the hollow of the ham. This uneasiness was greatly increased by even the slightest attempt to put the foot to the ground, and the patient felt he had not the slightest command over the knee-joint. Three months elapsed, and the patient had little more com- mand over the knee than on the day of the injury. During that period, he had tried warm and cold fomentations, frictions with stimulant and other embrocations, various ointments, oil, &c., still with little improvement. About a month after the injury, the bandages were dis- continued, and their place supplied by a finely fitting laced stock- ing, made of Saxony broad cloth, and the broad fiat steel spring was sewed to the back of it. I may here remark that, after a fair trial of the elastic and other stockings and bandages, I have come to the conclusion that the laced stocking made of Saxoiiy broad cloth, with all the seams on the outside, is superior to any yet in- vented, for affording regulated pressure over the leg, combined with a certain degree of elasticity. By the end of the fourth month, the patient was able to let the heel rest gently on the ground, but could not bear the weight of the body on the leg. Five complete months elapsed before the patient could dispense with the use of crutches, and trust to the aid of a stick. By this time, he could nearly rest the weight of the body on the injured leg, when supported by its laced stocking, bandage and spring, but he still felt he had no command over the knee-joint. During progression, the knee was kept immoveable, and the motion was limited to the ankle and hip-joints, the weight of the body being thrown on the stick. Even at this period, the leg, if attempted to be straightened, had the tendency to bend forwards on the thigh, so that the spring could not be dispensed with ; and more than thirteen months elapsed before its use could be discontinued. Even at the end of eighteen months from the date of the in- jury, the knee remained weak, and could not be thoroughly straightened without causing a disagreeable sensation, as if the knee were to bend backwards ; and still required to be supported by the laced stocking or by a stout knee-cap of chamois leather.