. Modern surgery, general and operative. ed in severe casesor when scraping fails after several trials. Formal excision is not frequentlyperformed, and the results cannot be regarded as very favorable. Listers Open Method of Excision.—Break up adhesions as completely aspossible by forcible movements. Apply a tourniquet or an Esmarch appa-ratus. The patient lies upon his back, the arm and the forearm being brought,from stage to stage, into the most desirable positions. Begin an incisionover the middle of the dorsum of the radius, on a level with the styloid process;carry it downward in the dire
. Modern surgery, general and operative. ed in severe casesor when scraping fails after several trials. Formal excision is not frequentlyperformed, and the results cannot be regarded as very favorable. Listers Open Method of Excision.—Break up adhesions as completely aspossible by forcible movements. Apply a tourniquet or an Esmarch appa-ratus. The patient lies upon his back, the arm and the forearm being brought,from stage to stage, into the most desirable positions. Begin an incisionover the middle of the dorsum of the radius, on a level with the styloid process;carry it downward in the direction of the inner edge of the articulation of the firstphalanx of the thumb with the first metacarpal bone, and when the knife reachesthe radial side of the second metacarpal bone alter the direction of the inci-sion and carry ,it downward in the long axis of the metacarpal bone to aboutits middle (Fig. 496, a). This is known as the radial incision, and the onlytendon divided is that of the extensor carpi radialis brevior muscle. The. Fig. 495.—Esmarchs splint for the treatment of a limb after excision of the elbow-joint. tissues upon the radial aspect of the incision are dissected up, the tendon of theextensor carpi radialis longior muscle is divided at its point of insertion (Bell),and all the soft structures are retracted outward, exposing the trapezium, whichis cut off from the rest of the carpus, but which is left in place, as its removalat this stage endangers the radial artery (Barker). By extending the handthe tendons are loosened and the carpus is cleared in the direction of the ulnarborder of the hand. Another incision is made, starting upon the inner surface of the wrist, 2inches above the articular surface of the ulna, and midway between the ulnaand the flexor carpi ulnaris tendon. This incision, which is known as theulnar incision, is carried down until it is opposite the middle of the fifth meta-carpal bone in the palm (Fig. 496, b). The dorsal li:> of thi
Size: 2760px × 905px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidmodernsurger, bookyear1919
