Exarticulation

And altho' it is a common Opinion, that Patients think the Pain and Loss of Motion proceeds from the Exarticulation or Luxation of the Thigh.Bone, from its Union with the Huckle-Bone, yet that is a false Notion, and impossible that the Articulation can suffer a Luxation, by Reason of the Thickness and Strength of the Ligaments and Circumjacent Tendons.

In this disorganization both the surrounding soft and hard parts are involved, and in consequence of the tumefaction and caries, there is produced at the same time exarticulation or spontaneous luxation which is invariably the effect of it.

It was a case of exarticulation, or compound luxation of the os-innominatum and sacrum, the exarticulation extending about half way down the bone, and the fracture from thence irregularly to the greater sacro-ischiatic notch.

If this rule is neglected there is grat danger of recurrence or of the establishment of habitual exarticulation, subluxation, or a snapping sound during eating.

Three cases were then related in which amputation at the middle of the thigh had been followed by osteomyelitis in the stump, but in which cures had been obtained without exarticulation.

The operation of exarticulation presents the following advantages over amputation performed in the continuity of the diseased bure in cases of osteo-myelitis:

Even after early amputation and exarticulation one soon sees recurrence and lung metastases.