A practical treatise on fractures and dislocations . the defects of Malgaignes hooks. Its peculiarities i Volkmann, Cent. f. Chir., 1880,24. 2 London Lancet, Nov. 22, 1879. 3 Valette, Poinsot, French ed. of this treatise, p. 611. * Severin, Chir. efficacis, partii. chap. vii. Malgaigne, op. cit, torn. i. p. 775. 5 Amer. Surg., St. Louis, vol. i. 1885. 6 New York Med. Journ., Dec. .31, 1889. TREATMENT OF FRACTURES OF THE PATELLA. 445 will be understood from the illustration. It is applied as follows: An ordinarystraight posterior knee-splint having been applied, and the knee and instrumentrende
A practical treatise on fractures and dislocations . the defects of Malgaignes hooks. Its peculiarities i Volkmann, Cent. f. Chir., 1880,24. 2 London Lancet, Nov. 22, 1879. 3 Valette, Poinsot, French ed. of this treatise, p. 611. * Severin, Chir. efficacis, partii. chap. vii. Malgaigne, op. cit, torn. i. p. 775. 5 Amer. Surg., St. Louis, vol. i. 1885. 6 New York Med. Journ., Dec. .31, 1889. TREATMENT OF FRACTURES OF THE PATELLA. 445 will be understood from the illustration. It is applied as follows: An ordinarystraight posterior knee-splint having been applied, and the knee and instrumentrendered thoroughly aseptic, the movable pair of hooks are adjusted to fit onefragment and firmly clamped to the cross-bar. Four punctures are made witha tenotome, or small bistoury, through the integument down to the bone, atpoints corresponding to the insertion of the hooks. The hooks having the setscrew (a) are removed from the bar and adjusted, the points being passed throughthe punctures and pressed into the bone. The second pair are applied to the. Otiss hooks for fractures of the patella. other fragment in a similar manner; the fragments are now brought together asnear as possible by manual force, the main bar is slipped through the slot on thecross-bar of the first pair of hooks and clamped in position by a turn of thescrew (a); any separation which may still exist maybe overcome by the thumb-screw (c).] Norris1 knew of one case in which the fragments were exposed and approxi-mated by wire (Dec. 1842), and the patient died on the fourth day. Dr. J. RheaBarton, of Philadelphia, operated in the same manner and his patient Moses Gunn, of Chicago, lost his patient from Dr. Cabot,4of Boston, had the same result. Cooper5 and Logan,6 of San Francisco, madea similar operation, and Dr. Byrd7 says it was made many years ago by McClelland, of Philadelphia. The precise dates and results of the threelatter operations are not published. Since the introduc
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