American practice of surgery : a complete system of the science and art of surgery . Coronal Section (diagrammatic) through theRadio-carpal, Carpal. Carpo-metacarpal, and Intermeta-carpal Joints, to Show Joint Cavities and Interosseous Lig-aments. (From Cunninghams Textbook of Anatomy.) distal joint of the thumb may give risethenar space. Infections of the middle and ring fingers may lead to involvement of thedorsal subaponeurotic space. Involvement of the dorsal subcutaneous space is possible in any infection ofthe fingers or thumb. From the anatomical details mentioned above it naturally fol
American practice of surgery : a complete system of the science and art of surgery . Coronal Section (diagrammatic) through theRadio-carpal, Carpal. Carpo-metacarpal, and Intermeta-carpal Joints, to Show Joint Cavities and Interosseous Lig-aments. (From Cunninghams Textbook of Anatomy.) distal joint of the thumb may give risethenar space. Infections of the middle and ring fingers may lead to involvement of thedorsal subaponeurotic space. Involvement of the dorsal subcutaneous space is possible in any infection ofthe fingers or thumb. From the anatomical details mentioned above it naturally follows, accord-ing to Kanavel, that, if the middle palmar space is to be opened, an incisionshould be made in the skin over the metacarpal space between the middleand ring fingers, just where the middle palmar crease crosses said space. Theincision may safely be made through the palmar aponeurosis, but the subjacent les should be perforated with an artery forceps the point of which shouldbe forced through to the dorsum of the hand. Through-and-through drainage WOUNDS OF JOINTS. 745. is always indicated, according to Kanavel, but it is highly probable that he isunnecessarily radical in this recommendation. The thenar space is best opened by an incision made on the radial side ofthe index metacarpal. Incisions in the metacarpal spaceswill most efficiently drain the dorsalsubaponeurotic space, and at thesame time all danger of injuring thetendons will be avoided. Should the pus pass under theannular ligament and appear in theforearm, the accumulations must beevacuated wherever found. In somecases the infection becomes so wide-spread and advances so rapidly thatamputation becomes the conservativemethod of treatment. Prognosis.—When the disease re-mains confined to one or more jointsof the fingers or hand there is noserious threatening of life, but theinfected joints become stiff, the anky-losis, as a rule, being permanent andirremediable. Because of the in-convenience and uselessne
Size: 1352px × 1847px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
