. Manual of operative surgery. Fig. 1407. Fig. 1408. Figs. 1407 and 1408.—Sites for incisions. (Kanavel.) 1136 OPERATIONS FOR INFECTIVE LESIONS OF THE HAND side of the middle metacarpal. It should be remembered that this space liesdeep in the palm, just above the adductor transversus. Fifth, the middle palmar space, with its three diverticula below along thelumbrical muscles, limited by the middle metacarpal bone upon the radial side,overlapped by the ulnar bursa upon the ulnar side, and separated from thethenar space by a partition which is very firm everywhere except at the proximalend, wher
. Manual of operative surgery. Fig. 1407. Fig. 1408. Figs. 1407 and 1408.—Sites for incisions. (Kanavel.) 1136 OPERATIONS FOR INFECTIVE LESIONS OF THE HAND side of the middle metacarpal. It should be remembered that this space liesdeep in the palm, just above the adductor transversus. Fifth, the middle palmar space, with its three diverticula below along thelumbrical muscles, limited by the middle metacarpal bone upon the radial side,overlapped by the ulnar bursa upon the ulnar side, and separated from thethenar space by a partition which is very firm everywhere except at the proximalend, where it is rather thin. A small isthmus can be found leading from theproximal end of the space under the tendons and ulnar bursa at the wrist up intothe Fig. 1409.—Drainage of palm. {KauavcL; Figures 1407, 1408, and 1409 show the best sites for incisions in infectionsof the hand and the best route for securing drainage of the midpalmar andthenar spaces. In any case of extensive or deep suppuration of the handwhen operation has been decided on, it is well if possible to administer a gen-eral anesthetic, apply an elastic constrictor to the upper arm and operatedeliberately with a precision rendered possible by a knowledge of anatomyand an absence of blood. After providing for drainage, apply liberal dressings and use Biers hyper-aemia by means of an elastic constrictor. As an alternative one may evacuatethe pus by appropriate incisions and apply h\-peraEmia by Klapps suctionmethod which has given the author very gratifying results. WOUNDS OF HAND II37 Inciskd Wounds of the Hand must be treated on ordinary surgical princi-ples, tendons, if divided, must be repaired and cleanliness sought. Many woundsof the hands are very much lacerated
Size: 1312px × 1904px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
