Critique . a luxationof the hip on the dorsum of the illium. Under advice the patient was built up by a nourishingdiet and the circulation ofthe limb improved by massage. On October 15, 1901, hewas taken to the Homeo-pathic Hospital and pre-pared for the operation,which was performed on Oc-tober 17th. Drs. S. and C. N. Hart as-sisting. An incision five and oneeighth inches long was madeon the anterior aspect of thethigh, passing through theskin and superficial fasciadown to the muscles, whichwere separated, without cut-ting, ,with the handle end ofthe scalpel and fingers.^Vhen the bon
Critique . a luxationof the hip on the dorsum of the illium. Under advice the patient was built up by a nourishingdiet and the circulation ofthe limb improved by massage. On October 15, 1901, hewas taken to the Homeo-pathic Hospital and pre-pared for the operation,which was performed on Oc-tober 17th. Drs. S. and C. N. Hart as-sisting. An incision five and oneeighth inches long was madeon the anterior aspect of thethigh, passing through theskin and superficial fasciadown to the muscles, whichwere separated, without cut-ting, ,with the handle end ofthe scalpel and fingers.^Vhen the bone was reachedthere was found to be noperiosteum over the callousforming the union of thebone on its anterior aspect,while it was complete on the posterior surface. This waspeeled from the bone and protected from injury while thebone was refractured, by the aid of a chisel, mallet and theHays saw. The ends of the fractured bone were then sawed oft0 tofreshen them. By extension and counter extension the inch. —APPEARANCE UFTHk UMBAT THEPRESENT. AFTER REFRACTUKE OF THEFEMUR AND SUBSEQUENT TREATMENT. THE CRITIQUE. 19 and three-quarters shortening was overcome by stretching thecontracted muscles, which required the combined efforts ofmy assistants and myself. Two holes were then drilled in each fragment, one a halfinch from the end of the bone, the other three-quarters of aninch from the first. In these holes the gold-plated screws were inserted andthe clamp adjusted to the exposed ends of the screws, thusholding the ends of the fractured bone in apposition and inline. This is known as the Parkhill clamp and screw is admirably adapted for such cases. The wound was then closed bythe use of deep silk worm sutures,drawing the parts close aroundthe four small screws, no drain-age being used. The exposed end of the clampwas adjusted a sufficient distancefrom surface of limb, permittingthe proper dressing of the patient was then placed inbed with a long, mod
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