Examination of Two Still-born Children.

Some further light may be thrown upon the human bursæ by an examina­tion of two still-born children I dissected in 1908 in Lewisham infirmary, and give here the results as to the more important subcutaneous bursæ.

Male Child: full term.

Shoulder: bursæ under acromion processes absent.

Elbow: bursæ over outer condyle of humerus present.

"  " inner  "    "  absent.
"  " olecranon both present.

Wrist: bursæ over styloid process of ulna present.

"  "  "   "  of radius present.

Hand: bursæ over metacarpo-phalangeal joints D 1 absent, D 2, 3, 4, 5 present.

bursæ over phalangeal joints, first set present, second set absent.

Hip: bursæ over anterior superior spine of the ilium both absent.

Knee: prepatellar bursæ well-developed.

Ankle: bursæ over both malleoli present:

bursæ beneath tendo achillis well-developed.

Great toe: plantar bursa present.

Little toe: plantar bursa absent.

Toes: D 1 (great toe) bursa over metatarso-phalangeal joint present.

D 2, 3, 4, 5 bursæ over metatarso-phalangeal joints absent.

Bursæ over Phalangeal joints.

D 1 present.

D 2, 3, 4, none over either of the phalangeal joints.

D 5 bursa present over the first and absent over the second phalangeal joint.

This example of a still-born, but otherwise normal infant illustrates well the previous statement that certain bursæ are congenital and others of less functional importance are formed after birth. Whereas the olecranon, wrist, patellar, ankle and tendo achillis bursæ are fully formed, those under the acromion processes, one of those of the condyles of the femur, and the digits of the hand, those over the superior anterior spines of the ilium and those of the foot are little if at all developed in this case.

Another still-born child at seven months was also dissected and this had well-formed prepatellar bursæ, scanty ones over the olecranon processes, also over the small joints of the hand and foot where they were difficult to isolate and over the malleoli they were only slightly developed.

A fœtus in spirit I examined and found no commencement of a prepatellar bursa.