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Updated: May 23, 2025
Cellulitis of the sole of the foot may follow whitlow of the toes. In the region of the ankle cellulitis is not common; but around the knee it frequently occurs in relation to the prepatellar bursa and to the popliteal lymph glands, and may endanger the knee-joint.
It may occur as an independent affection, or may be associated with disease in an adjacent bone or joint. It is met with chiefly in the prepatellar and subdeltoid bursæ, or in one of the bursæ over the great trochanter.
While friction and pressure are the most evident factors in their production, it is probable that there is also some toxic agent concerned, otherwise these affections would be much more common than they are. Of the countless housemaids in whom the prepatellar bursa is subjected to friction and pressure, only a small proportion become the subjects of housemaid's knee. Clinical Features.
#Infective bursitis# frequently follows abrasions, scratches, and wounds of the skin over the prepatellar or olecranon bursa, and in neglected cases the infection transgresses the wall of the bursa and gives rise to a spreading cellulitis.
As these are best illustrated in the different varieties of prepatellar bursitis, it is convenient to take this as the type. In a number of cases the inflammation is acute and the patient is unable to use the limb; the part is hot, swollen, and tender, and fluctuation can be detected in the bursa.
These facts furnish us with indications as to the seat and method of amputation. Experience has proved that in senile gangrene of the lower extremity the most reliable and satisfactory results are obtained by amputating in the region of the knee, care being taken to perform the operation so as to leave the prepatellar anastomosis intact by retaining the patella in the anterior flap.
When shut off from the joint it may suffer independently, and when distended with fluid forms a horse-shoe swelling above the patella. In front of the patella and its ligament is the prepatellar bursa, which may have one, two, or three compartments, usually communicating with one another.
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