. American practice of surgery ; a complete system of the science and art of surgery . chance of perma-nent disability. Treatment.—All the authorities advise rest andbandaging unless complete rupture is very plan of treatment is probably sufficient for theplantaris and for partial ruptures of the quadriceps;but, in the case of the head of the biceps, its belly, theligamentum patellae, the tendo Achillis, and all ten-dons and muscles of much functional importance,any considerable rupture should be an indication forexploration and suture. The result of aseptic suturein these latter
. American practice of surgery ; a complete system of the science and art of surgery . chance of perma-nent disability. Treatment.—All the authorities advise rest andbandaging unless complete rupture is very plan of treatment is probably sufficient for theplantaris and for partial ruptures of the quadriceps;but, in the case of the head of the biceps, its belly, theligamentum patellae, the tendo Achillis, and all ten-dons and muscles of much functional importance,any considerable rupture should be an indication forexploration and suture. The result of aseptic suturein these latter cases is better than can be expectedfrom non-interference. Muscle Hernia.—A muscle hernia results whenthe rupture of its sheath allows the muscle to pro-trude. Such a rupture results from violent and un-usual contractions of the underlying muscle, and alsoresults from the stretching of fascial scars. In a few cases muscle herniaappears to have been due to a localized thinning and weakening of the musclesheath. Occurring spontaneously it is most frequent in the adductors of cav-. FiG. 61.—Method of Treat-ing a Herniated Muscle. Thefigure shows diagrammatical-ly the manner in which, whenthe torn edges of the fasciacannot be accurately suturedtogether, the gap can beclosed by bridging it withcatgut after the hernia of themuscle has been reduced.(Cheyne and Burghard.) SURGICAL DISEASES OF MUSCLES. 403 alrymen, but may occur at any point of local weakness. The symptoms are asoft swelling which is shown, by the fact that voluntary contraction takes placein it, to consist of muscle. Treatment.—This has not been very satisfactory, the best results havingfollowed incision and suturing of the fascial or aponeurotic gap (Fig. 61) afterreduction or excision of the protruding muscle. Subsequent fixation of theparts for a period of about twenty days will be found necessary. Inflammations, Tumors, and Parasites. The long list of degenerative changes which sometimes occur in muscle has
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