. Annals of surgery . 841 HENRY H. M. LYLE Treatment of Mutilations of the Hand Where the Thumb Alone Remains.—The problem is to produce an opposition member. If any metacarpals arepresent this can be done either by clefting or by transplantation of a toe or afinger, or by a free bone transplant. In a case where the thumb was intactand the four other fingers and metacarpals missing. Albee syntheticallygrafted a stationary finger by the Italian method. The bone for the necessaryrigidity was obtained by free graft from the tibia. This wedge-shaped bone. Fig. h a, B.—Perthes operation for mutilat
. Annals of surgery . 841 HENRY H. M. LYLE Treatment of Mutilations of the Hand Where the Thumb Alone Remains.—The problem is to produce an opposition member. If any metacarpals arepresent this can be done either by clefting or by transplantation of a toe or afinger, or by a free bone transplant. In a case where the thumb was intactand the four other fingers and metacarpals missing. Albee syntheticallygrafted a stationary finger by the Italian method. The bone for the necessaryrigidity was obtained by free graft from the tibia. This wedge-shaped bone. Fig. h a, B.—Perthes operation for mutilation of thumb, where only small portion of first meta-carpal remains. Index metacarpal divided I cm. above its base and transplanted to stump of firstmetacarpus, it was rotated 93^ and sutured in the position of grasp. A strong useful hand was ob-tained. (See Perthes.) graft being driven into a mortise in the os magnum, made a stationary butstrong opposing member. Sunmmry.— The dense, cold, stiff fingers with smooth bluish-red skinthat are left after the storm of infection has passed are poor material for anyreconstructive surgery. The lesions we encounter, as a rule, involve severalstructures and their treatment often calls for different procedures at dif-ferent stages. \\hen to interfere surgically requires judgment, knowledgeand experience. The maximum nutritional and functional improvement should be obtainedby conservative means before embarking on any difficult or extensive recon-structive surgery. The treatment of many of these cases
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
