Journal : Photographic review of medicine & surgery ; vol. 2., no. 1.
Philadelphia : J. B. Lippincott & Co., 1871-72.
Description : p. 5,  pl. ; ill.: 1 photo. ; 24 cm.
Photograph : mounted albumen.
Subject : Tibia — Necrosis, amputation.
A GERMAN, twenty-three years of age, presented himself at the clinic of the Jefferson Medical College, in May, 1870, on account of a remarkable and probably unique deformity of the right leg, due to the loss of four inches of the necrosed tibia when he was two years and a half old, and neglect in keeping the limb extended during the after-treatment. When not supported, the foot was adducted, and its inner margin elevated so that the sole was directed towards the opposite leg. As exhibited in the photograph, the distortion of the leg consisted in a deep concavity along its inner side, while its outer side presented a corresponding curve, so that the instep was only about three inches below the knee. The man had remarkable control over the muscles of the leg and foot, but the limb was useless for purposes of progression.
On the 15th of May the limb was amputated, just below the tubercle of the tibia, by a small anterior and a long posterior flap, the head of the fibula having been disarticulated from the tibia in the first stage of the operation. The man recovered without an untoward symptom, union being perfect on the thirteenth day.
Dissection of the limb showed full development of the muscles of the leg and foot. The upper and lower portions of the tibia were conical, about three inches in length, and united by a dense, thick, fibrous tissue.