Modern surgery, general and operative . n may be responsible for dissemination of the bacteria. If an abscess forms, incise it with the most thorough antiseptic care, let thefluid drain away, irrigate the cavity with salt solution, remove any sequestra,inject with iodoform emulsion, sew up without drainage, and dress antiseptic-ally. In some cases the sequestrum is extra-articular. In many cases nosequestrum is found. If this method fails, drainage must be employed. The oldplan of not operating until rupture was seen to be inevitable would be wrongto-day. To open early and antiseptically often
Modern surgery, general and operative . n may be responsible for dissemination of the bacteria. If an abscess forms, incise it with the most thorough antiseptic care, let thefluid drain away, irrigate the cavity with salt solution, remove any sequestra,inject with iodoform emulsion, sew up without drainage, and dress antiseptic-ally. In some cases the sequestrum is extra-articular. In many cases nosequestrum is found. If this method fails, drainage must be employed. The oldplan of not operating until rupture was seen to be inevitable would be wrongto-day. To open early and antiseptically often means rapid healing, the preven-tion of burrowing, a lessened danger of visceral infection, and an earlier contrast to what happens when a very large cold abscess is opened, hecticwill rarely arise when a tuberculous joint is opened and drained with aseptic care. Excision of the hip is to be performed when there is a large sequestrumor severe fistulse (Garre, Deutsch. med. Woch., 1905, Nos. 47 and 48); HIP-JOINT DISEASE. Plate. I, ?2. Effects on the Lumbar Spine of Flexing: and Extending the Diseased Leg in Hip Disease(Albert). 3,4. Positions in Coxalg a (Albert). 5. in Hip Disease (Treves). 6 Ex-tension of the Lirnb in a Flexed and Adducted Position (Treves). 7. Extension of the Limb in aFlexed and Abducted Joint (Treves). Knee-joint Disease 631 when the head of the femur is detached and lies loose in the joint; when profusesuppuration continues for a long time, and other methods fail to arrest it;when amyloid disease is threatening; or when very faulty position is inevitablewithout operation. Excision is an operation of considerable danger, and theolder the person, the greater the danger. Schede advocates arthrectomy insome cases as a substitute for resection. Senn tells us that opinion as to resec-tion has greatly changed of late, and it is now taught that the operation isadvisable in all cases where fixation, extension, intra-articular and parenchy-matou
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