A System of Practical Surgery V.3

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Prognosis. — The chances of recovery without operation are as unfa- vorable in these small joints as they are in tuberculous affections of the joint in middle and advanced life.
Treatment. — Usually it is not difficult to decide between arthreetomy, resection, and amputation. Very often the disease is accompanied by an advanced pulmonary tuberculosis.
CONTRACTURES, 1 ANKYLOSIS, AND DEFORMITIES OF THE HAND.
On practical grounds it is advisable to consider contractures and ankylosis together. The
... paralytic and neuropathic forms of contrac- ture were discussed in the section on the Upper Arm and Forearm, because the source lay outside of the hand, and because they are more often the results of affections and lesions at a higher level. The de- formities in lupus causing contractures were discussed under Tuber- culosis of the Skin. Helferich was the first to call attention to con- genital interphalangeal ankylosis of the thumb in ossifying myositis.
It was found in almost three-fourths of the cases examined for that purpose.


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