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Updated: May 11, 2025
When several bones and joints are simultaneously affected, and there are sinuses with mixed infection, amputation is usually indicated, especially in adults. #Tuberculous dactylitis# is the name applied to a diffuse form of the disease as it affects the phalanges, metacarpal or metatarsal bones.
As a rule, it is only in superficially placed bones, such as the tibia, ulna, clavicle, mandible, or phalanges, that tuberculous disease in the marrow gives rise to signs sufficiently definite to allow of its clinical recognition.
He stood there, alone with his dog, watching the crowd on the far slope as it surged upward in the direction of the committee tent. Only when the black mass had packed itself in solid phalanges about that ring, inside which, just a year ago, he had stood in very different circumstances, and was at length still, a wintry smile played for a moment about his lips. He laughed a mirthless laugh.
Lameness is the first manifestation of this affection and weight bearing is painful in direct proportion to the extent of injury present. Volar flexion of the phalanges relieves tension on the parts; therefore, this position is assumed while the subject is at rest.
In Equus, finally, the crowns of the grinding-teeth become longer, and their patterns are slightly modified; the middle of the shaft of the ulna usually vanishes, and its proximal and distal ends ankylose with the radius. The phalanges of the two outer toes in each foot disappear, their metacarpal and metatarsal bones being left as the "splints."
In the ichthyosaurus, in the plesiosaurus, in the whales, in the porpoises, in the seals, and in others, we have shortening of the bones, but no reduction in the number either of the fingers or of their joints, which are, on the contrary, multiplied in Cetacea and the ichthyosaurus. And even in the turtles we have eight carpal bones and five digits, while no finger has less than two phalanges.
In an inflamed condition of the lateral side of the phalanges, unequal weight-bearing such as a rough road surface will, by virtue of the leverage which the solar surface of the foot affords, cause undue strain upon such inflamed parts, and increased lameness is evident.
A myxomatous swelling attacked the phalanges and effected a complete absorption of the terminal phalanx. It did not advance as far as gangrene or exfoliation of bone. At the time of report the whole ten fingers were involved; the bones seemed to be thickened, the soft parts being indurated or sclerosed. In the right index finger a completely sclerosed ring passed around the middle phalanx.
But where luxation of phalanges accompanies sprain, reposition and immobilization are necessary that is if cases are thought likely to benefit by any treatment. Luxations Dislocations. Luxation or dislocation is a condition where the normal relation between articular ends of bones has been deranged to the extent that partial or complete loss of function results.
Similarly, hands not having been given on behalf of glove-makers, they are visibly destined for all the purposes which the metacarpal bones and the phalanges and the circular muscle of the wrist may procure for us. Cicero, who doubted everything, did not, however, doubt final causes. It seems especially difficult for the organs of generation not to be destined to perpetuate the species.
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