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Updated: June 22, 2025
Should recovery take place, repair is usually attended with union of the opposing articular surfaces either by fibrous tissue or by bone. #Conditions of Impaired Mobility of Joints.# There are four conditions of impaired mobility in joints: rigidity, contracture, ankylosis, and locking.
The occurrence of ankylosis in a joint before the skeleton has attained maturity does not appear to impair the growth in length of the bones affected; ankylosis of the temporo-maxillary joints, however, greatly impairs the growth of the mandible. When there is arrest of growth accompanying ankylosis, it usually depends on changes in the ossifying junctions caused by the original disease.
The leather splints are placed mesially and laterally and, of course, need to extend as high as the proximal end of the radius. Subjects must be kept in slings until union of bones has become established, and as a rule there will then exist marked ankylosis. There is no particular difference in the handling of carpal luxation and dislocation of other bones.
Ankylosis is the term applied when impaired mobility results from changes involving the articular surfaces. It is frequently combined with contracture. The resulting stiffness, therefore, varies from a mere restriction of the normal range of movement, up to a close union of the bones which prevents movement.
Saviard informs us that he saw a patient at the Hotel Dieu who had a horn like that of a ram, instead of a nail, on each great toe, the extremities of which were turned to the metatarsus and overlapped the whole of the other toes of each foot. The skeleton of Simore, preserved in Paris, is remarkable for the ankylosis of all the articulations and the considerable size of all the nails.
The fusion of the cartilaginous surfaces is preceded by the spreading of a vascular connective tissue, derived from the synovial membrane, over the articular cartilage. It may follow upon fibrous or cartilaginous ankylosis, or may result from the fusion of two articular surfaces which have lost their cartilage and become covered with granulations.
When these tendon sheaths are opened, there follows a reaction which is quite analogous to that which exists in arthritic synovitis, but instead of ankylosis, adhesions with thecal obliteration occur. Rarely there result cartilaginous and osseous formations. The constitutional disturbances which characterize this condition vary with the degree of distress occasioned.
However, if synovial discharge persists too long because of tardy closure of an open joint, there is great danger of infection gaining entrance into the synovial cavity, or in some instances, desiccation of endothelial cells of the articulation occurs, in areas, and the reactionary inflammation eventually results in ankylosis.
Arthroplasty is most successful in ankylosis following upon injury; when the ankylosis results from some infective condition such as tuberculosis or gonorrhœa, it is liable to result in failure either because of a fresh outbreak of the infection or because the ankylosis recurs.
J. R. Bass, the well-known "ossified man" of the dime museums, has been examined by many physicians, and was quite intelligent and cheerful in spite of his complete ankylosis.
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