THE ADOLESCENT TIBIAL TUBERCLE

An Anatomical and Pathological Study.

We may then conclude: That the affection is one peculiarly associated with adolescence and that it is most apt to occur at the time in the individual case when the cartilaginous space is least between the tibia1 tubercle and the diaphysis, at a time just before union takes place.

That it is liable to occur at any time after ossification of the tongue-like process.

That it may occurs on both sides, but that one side seems to be the usual occurrence, one side evidently developing somewhat earlier than the other, the right side probably developing before the left. The right knee seems to be affected more frequently then the left, as Schlatter concludes. This I ascribe to the fact that the right leg is stronger than the left and is used more. That is to say, the musclar action is greater. It is also more advanced in ossification and the cartilaginous plate becomes thinner and thereby weaker at an age when the "give" to the cartilage of the left side is still present.

That girls may be affected as well as boys, a point in which I believe I differ from all other observers; and that girls are affected at a considerably earlier period than boys, the onset in two of my girls being at the tenth year.

That boys seem more liable to the affection between the thirteenth and fifteenth year.

That the etiological factor is muscular action of the anterior thigh muscles and that it almost always occurs in especially well-developed children.

That in this class of cases should be included only mechanical irritations and not infections.

That the condition has been recognized for a great many years, but that since the use of the X-rays diagnosis and prognosis may be much more certain and that treatment may be more rationally carried out, as the full extent of the injury can be positively ascertained.

That recovery may be expected promptly when the diagnosis has been established.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?