Figure 217, taken from Hutchinson's "Archives of Surgery,"
represents an extreme case of deformity of the knee-joints in a
boy of seven, the result of severe osteoarthritis. The knees and
elbows were completely ankylosed.
Infantile spinal paralysis is often the cause of distressing
deformities, forbidding locomotion in the ordinary manner. In a
paper on the surgical and mechanical treatment of such
deformities Willard mentions a boy of fourteen, the victim of
infantile paralysis, who at the age of eleven had never walked,
but dragged his legs along. His legs were greatly twisted, and
there was flexion at right angles at the hips and knees. There
was equinovarus in the left foot and equinovalgus in the right.
By an operation of subcutaneous section at the hips, knees, and
feet, with application of plaster-of-Paris and extension, this
hopeless cripple walked with crutches in two months, and with an
apparatus consisting of elastic straps over the quadriceps
femoris, peroneals, and weakened muscles, the valgus-foot being
supported beneath the sole. In six months he was walking long
distances; in one year he moved speedily on crutches. Willard
also mentions another case of a girl of eleven who was totally
unable to support the body in the erect position, but could move
on all fours, as shown in figure 219.
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