File:American practice of surgery - a complete system of the science and art of surgery (1906) (14595739618).jpg

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
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Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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shown by Virchow, and the fact explains the rare casesin which this form of exostosis is seen near the centre of the diaphysis. Carti-laginous exostoses are encountered most commonly in the long hones, theupper end of the tibia being the seat of predilection (Fig. 181). Next to this,the lower end of the femur is the most common seat: and then follow, inthe order in which they are found to he affected, the other long bones, with*Deut. mod. Wochonschr.. 1904. xxx.. 941. TUMORS ORIGINATING IN BONK. 40< the exception of those of the hand and foot, where these exostoses rarely occur.They are also seen on the pelvis, on the scapula, and rarely on the head,vertebra?, and sternum. Cartilaginous exostoses occur in the first two decades of life, that is, duringthe period of active bony growth, and it is an extremely rare occurrence forthem to arise after the twentieth year. If they develop previously to this theycease growing with the complete formation of the skeleton. Sex has no influence,
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Fig. 181.—Cartilaginous Exostosis of the Head of the Tibia. (Massachusetts General Hospital.) and the questions of heredity and rachitis do not have as important a placein the etiology as is the case in the multiple form, but every grade between thesingle and the advanced multiple type may be seen. Pathology—In gross, the tumors appear as irregular, usually long, roundedoutgrowths, varying in size, with pointed, tuberous, or mushroom-shapedheads. They may, however, be of any shape, are often branching, and generallydo not extend at right angles to the bone, but grow backward over the shaft. They are often covered by a bursa containing more or less fluid and at times 408 AMERICAN PRACTICE OF SURGERY. filled with irregular free cartilaginous bodies (exostosis bursata). Histologically,they are composed of normal spongy bone covered with a denser layer of corticalbone and tipped with hyaline.cartilage, from which they grow, bone being formedas in the Donnal epiphysis. Symptoms.—The

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