The treatment of fractures . —Fracture of patella; fragment approximated and sutured with silver wire. Wireseen m .\itu (X-ray tracing. C. B. Portei I. be satisfactory as far as the functional usefulness of the knee isconcerned. The operative method consumes less time in conval-escence and an excellent result is achieved, but operation exposes OPERATIVE TREATMENT 339 to the danger of sepsis. If sepsis results, the following conditionsare imminent: A stiff knee, amputation of the thigh, and possiblydeath from septic infection. Whether operation shall be done ornot, therefore, depends up
The treatment of fractures . —Fracture of patella; fragment approximated and sutured with silver wire. Wireseen m .\itu (X-ray tracing. C. B. Portei I. be satisfactory as far as the functional usefulness of the knee isconcerned. The operative method consumes less time in conval-escence and an excellent result is achieved, but operation exposes OPERATIVE TREATMENT 339 to the danger of sepsis. If sepsis results, the following conditionsare imminent: A stiff knee, amputation of the thigh, and possiblydeath from septic infection. Whether operation shall be done ornot, therefore, depends upon the degree of safety with which it canbe performed. It is the surest method of securing perfect apposi-tion and bony union. It should be undertaken only by surgeonsof exceptional judgment and great skill, who have at commandskilled assistants, and who can work under the most rigid asepticconditions. The acute symptoms should be allowed to subside. Fig. 476.—Case: Freshly fractured right patella sutured with chromieized catgut. Resultafter eight weeks. Note flexion of leg to a right angle ; line of incision (Warren). before operation. The tissues require time to recover them-selves from the acute trauma. The operative treatment shouldbe confined to healthy individuals under sixty years of age ; tofractures with a separation of an inch or more of the bony frag-ments and extensive lateral fascial tears (the fascial tears may berecognized by joint distention and localized bulging) ; to casespresenting great joint distention that does not disappear should be seriously considered if the individuals occupationis arduous and necessitates much standing or walking. Thepatient should be informed as to the probable outcome by the 34-0 FRACTURES OF THE PATELLA two methods of treatment. The danger to life and limb shouldbe fairly stated. It should be remembered that the power ofextension of the leg is not materially limited by a
Size: 1410px × 1773px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectfractur, bookyear1901
