NEUROPATHIC ANKLE DUE TO LOCOMOTOR ATAXIA.
DR. B. FARQUHAR CURTIS, through Dr. Gibson, presented a man, thirty-eight years old, who began to complain of dizziness and uncertainty in gait about two and one-half years ago, and advanced locomotor ataxia is now present. Two years ago, with out sustaining any injury, his left ankle suddenly became much swollen and he lost control of the joint. The swelling was not accompanied by pain. Six months ago there was spontaneous dislocation of the left ankle, and the joint was very painful for several weeks. The pain then subsided.
Dr. Curtis's idea in presenting this case was to elicit sugges tions regarding the treatment.
The limb presents an enormous, rather doughy, swelling of the ankle, with inward displacement of the foot. The malleoli are much thickened and the internal malleolus detached. The bones of the tarsus appear altered also. The ligamentous attach ments are loose, and the foot cannot support the man's weight without a boot.
DR. GIBSON said the man could probably get along for some time in his present condition. If his life was prolonged, he might possibly be rendered more comfortable by the application of some orthopaedic apparatus or splint, with a high shoe on the opposite foot.