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31st. — He left the hospital. The contour of the ligament was natural, the patella movable, but the Glycomet Tablet joint stiff, flexion being Glycomet 850 only possible to trifling degree. The ankle was swollen and slightly painful, which indisposed him to walk. Nine weeks after the operation I examined him and found that he could flex the limb about thirty degrees, and from this point extend it completely and strongly. The ankle was slightly swollen and painful on walking, and has been a serious draw- back in his efforts to move the knee, which presents no signs of * Read before the New York Surgical Society, February 27, 1889. rheumatic inflammation. There Glycomet Gp 2 is reason to believe that the power of flexion will gradually increase.* These Glycomet 850 Mg experiences have excited my interest in the proper management of this injury, and especially in the question whether they should be treated by the older method of immovable apparatus and compressing bandages, or by Glycomet 1gm prompt suture of the tendon by means of surgical operation. I have, with the kind assistance of Dr. Albert H. Leyton, late house-surgeon at Bellevue Hospital, made a careful search through the literature of the subject, and I hope that the information thus obtained, though to me un- satisfactory, may serve as a basis for discussion if not for the formulation of any definite conclusions. The most complete study is an elaborate article by Maydl ("Ueber subcutane Muskel- und Sehnenzerreissungen," "Deutsche Zeitschrift fur Chirurgie," xvii and xviii), who in 1883 collected sixty-one cases of this injury in connection with fractures of the patella and ruj)ture of Glycomet Sr 500 its ligament, all of which had been treated without operation. Of the sixty- one cases, twelve were ruptures confined to the muscular substance, and it is not clear which of these two classes of cases has contributed to the final statement of the result. There were, of Glycomet Tablets these sixty-one cases, twenty-eight instances of complete healing— that is, with restoration of the func- tions of the muscle; in thirteen the recovery was incom- plete ; in thirteen it was not given ; and the remainder, seven in number, were old cases. These data as to the out- come of the injury are certainly unsatisfactory, but they may be fairly said to prove that complete recovery occurs in about half the cases. The same conclusion is reached by a consideration of the cases reported since Glycomet Gp2 1883, or omitted froni Maydl's table. Dr. Leyton has found fifteen instances of single and five of double rupture. Of the single ruptures, complete Glycomet 250 recovery took place in nine, in four it was incomplete, and the result was not stated in two. Of the five double ruptures, making ten in all, the result was not given in five ; in four recovery was stated to be incomplete, and complete in one. It should be stated that under " complete Glycomet Gp1 recovery " are counted the cases which are so reported, or Glycomet 500mg those in which " good recovery " is noted, as well as those accompanied bv the definite statement that all the functions Buy Metformin Online were perfect. Un- der the head of " incomplete recovery " are all those so ex- pressed and those in which defects in flexion and extension were noted, and, moreover, those of patients who are said to be able to walk well on a level, but unable to go up and down stairs; and, finally, those described as "improved," The Glycomet 500 Sr time which has Glycomet Price intervened Glycomet Gp between the injury and the statement of the results has varied so much that it has seemed wise to disregard it. It has varied from a few weeks to a year, and even more, and it should be mentioned that in several cases which have Glycomet 500 Mg been examined at later in- tervals than three or six months there has been found a marked improvement in function. This is especially true as regards the stiffness of the joint, which limits the Glycomet 500 power * Inspected three months after the operation ; flexion to a right angle. Iju-^ (?J6ax^ Ht.^ 422 IWLL: h'lJ/'/l'h'h' Glycomet Sr OF J UK QUAJJlUUKPS FEMOlilS TENDON. |N. Y. Mkd. Jouk., RUPTURE OF QUADRICEPS EXTENSOR TENDON. No. Buy Metformin nplM.rlir I Bex and age, BtlinHoti, " Mt>
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