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Updated: May 4, 2025
In Charcot's disease, bodies composed of bone are formed in relation to the capsular and other ligaments, and may be made to grate upon one another. The clinical features in this group are mainly those of the disease which has given rise to the loose bodies, and it is exceptional to meet with symptoms from impaction of the body between the articular surfaces.
Meanwhile, through all the bustle of departing and arriving friends, and through all the fast-strengthening hum of general talk, the voice of the unyielding doctor still murmured solemnly of "capsular ligaments," "adjacent tendons," and "corracoid processes" to Lady Brambledown, who listened to him with satirical curiosity, as a species of polite medical buffoon whom it rather amused her to become acquainted with.
The anterior portion of the capsular ligament forms sheaths for the extensor tendons, and both portions of the joint have an attachment around the distal end of the radius and another at the proximal end of the metacarpal bones. Etiology and Occurrence.
Fixed luxation may be of such character as to be practically irreducible because of extensive damage done to ligaments or cartilage. Where a complete luxation of the metacarpophalangeal joint exists, it is probable that in most cases sufficient injury to collateral and capsular ligaments has been done to render complete recovery improbable, if not impossible.
In aggravated cases the tips of the fingers disappear from progressive ulceration, and in the sole of the foot a perforating ulcer may develop. Arthropathies are occasionally met with, the joints becoming the seat of a painless effusion or hydrops, which is followed by fibrous thickening of the capsular and other ligaments, and terminates in stiffness and fibrous ankylosis.
One or two cases have been recorded in which a cartilaginous tumour growing from the synovial membrane has erupted through the joint capsule and infiltrated the adjoining muscles. Multiple cartilaginous tumours forming loose bodies are described on p. 544. Cysts of joints constitute an ill-defined group which includes ganglia formed in relation to the capsular ligament.
The symptoms manifested by the subject in such cases are the same as have been discussed heretofore and merit no special consideration. Prognosis. Unless very serious injury be done the articular portions of the scapula or the humerus, resulting in the destruction of the capsular ligament, prognosis is entirely favorable. Open Joint.
Ligaments which have to do with the locomotory apparatus are, for the most part, inelastic structures which are composed of white fibrous tissue and serve to join together the articular ends of bones; to bind down tendons; and to act as sheathes or grooves through which tendons pass, and as capsular membranes for retention of synovia in contact with articular surfaces of bones.
The limb from the fingers to that point acted as the "long arm," and the head and part of the neck of the humerus served as the "short arm." The inertia of the arm, left behind as it were, supplied the power, while the ruptured capsular ligament and displacement of the head of the bone would represent the work done. Congenital Dislocations.
In the handling of open joint capsules where the perforation of the capsular ligament is small and discharge of synovia does not immediately follow, there is presented a problem which is difficult to decide upon and that is the manner in which such wounds are to be handled.
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