. The principles of surgery . re is formed in thenewly-constructed case of bone, corresponding to the opening in theperiosteum. In fracture, without suppuration, ossification is begun bybone, is continued by periosteum, and where that is deficient, is sustainedby the surrounding parts, which assume periosteal character and func-tion ; and consequently the incasement of bone, under such circum-stances, is continuous. But here there is no substitute for deficientperiosteum; the surrounding soft parts have suppurated, and are thera- Fig. 134. Acute necrosis of the tibia. The bone extensively peri
. The principles of surgery . re is formed in thenewly-constructed case of bone, corresponding to the opening in theperiosteum. In fracture, without suppuration, ossification is begun bybone, is continued by periosteum, and where that is deficient, is sustainedby the surrounding parts, which assume periosteal character and func-tion ; and consequently the incasement of bone, under such circum-stances, is continuous. But here there is no substitute for deficientperiosteum; the surrounding soft parts have suppurated, and are thera- Fig. 134. Acute necrosis of the tibia. The bone extensively perished at a ; the cor-tical formation has begun to form. Fibula, as usual, unaffected.—Lislon. Fig. 135. Necrosis of tibia; more advanced. Cortical formation investing the greaterpart of the old bone.—Lislon. Fig. 136. Necrosis of tibia; in the chronic stage. Cortical, or substitute bone com-plete, and consolidated. At several points cloacae seen, leading down to the sequestra.—Liston. FORMATION OF NEW BONE. 427 Fig. selves reduced to the condition of an aperture or canal for discharge ofmatter. This, however, is not a disadvantage. On the contrary, were deficien-cies of periosteum invariably supplied by adventi-tious structure of similar capabilities, the corticalformation would also invariably be continuous ;purulent matter would be denied an outlet; and allthe pains and dangers of acutely-accumulating, and bdeeply-seated pus, would inevitably ensue. As it is,deficiency of periosteum is not supplied; and thecortical formation is at that point proportionally de-fective. A permanent aperture, termed Cloaca, re-sults (Fig. 136); communicating internally with thecavity which contains the sequestrum, opening intothe suppurated aperture and canal of the soft partsexteriorly, and of the greatest use in securingefficient discharge of purulent or other fluids. The external orifice of this dicharging canal isusually callous, and of an elevated or pouting cha-racter. It is ter
Size: 938px × 2666px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, booksub, booksubjectsurgicalproceduresoperative
