Operative surgery, for students and practitioners . ated from the bone, alongwith their attached tendons, hanging together in one continuouslayer; so that, when we are ready to resect, the denuded upper endof the femur lies in a sort of sac which is made of the above-namedstructures, and Avhich all hang together, continuous with one another,and it is out of this hood or sac that we deliver the upper end ofthe bone for resection. In closing the wound the upper edges ofthe hood should be included in the sutures, except the part that isleft open for drainage. AMPUTATIONS, RESECTIONS, ETC. 821 Pla
Operative surgery, for students and practitioners . ated from the bone, alongwith their attached tendons, hanging together in one continuouslayer; so that, when we are ready to resect, the denuded upper endof the femur lies in a sort of sac which is made of the above-namedstructures, and Avhich all hang together, continuous with one another,and it is out of this hood or sac that we deliver the upper end ofthe bone for resection. In closing the wound the upper edges ofthe hood should be included in the sutures, except the part that isleft open for drainage. AMPUTATIONS, RESECTIONS, ETC. 821 Plating for Fracture (Lane).—In fractures both simple andcompound, where the fragments cannot bo reduced or retained insatisfactory position, they may be securely held with metal plates,—Lanes bone plates. These are provided in various shapes and sizesfor the different bones. The plates arc applied directly to the surfaceof the fragments. In compound fractures the wound already presentmay be sufficiently enlarged to reach the fragments. In simple. Fig. 362.—Plating for Fracture (Lane). Shows plate applied to femur and securedby screws to upper and lower fragments. fractures it will be necessary to expose the fragments through anincision in the soft parts, the incision being placed so as to producethe least possible damage to important structures. It may be necessaryto freshen the ends of the fragments with the chisel, or curette, means of rotation, extension, etc., the fragments are brought intoaccurate apposition. This may be facilitated by employing the specialbone forceps, levers, etc., devised by Lane. The plate is appliedwithout detaching the periosteum. Corresponding to the screw-holesin the plate, holes are drilled in the bone, first upon the distal frag- 822 LOWER EXTREMITY. ment and the screws^ then driven in with the screw-driver. Thefragments are again brought into the proper position and the screw-holes drilled in the proximal fragment and the screws drive
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