American practice of surgery : a complete system of the science and art of surgery . uch a case FRACTURES. 93 the resection of a sufficient portion of the unbroken bone may be other cases it may be expedient to wire the fragments or attach them one tothe other with screws, silkworm gut, absorbable sutures, or other devices. Asuitable method of osteoplasty may be of utility in such instances. (Figs. 19and 20.) In a most practical article on The Operative Treatment of Fractures, inthe Journal of the American Medical Association of January 13th and 20th,1906, Dr. James A. Kelly, of Ph
American practice of surgery : a complete system of the science and art of surgery . uch a case FRACTURES. 93 the resection of a sufficient portion of the unbroken bone may be other cases it may be expedient to wire the fragments or attach them one tothe other with screws, silkworm gut, absorbable sutures, or other devices. Asuitable method of osteoplasty may be of utility in such instances. (Figs. 19and 20.) In a most practical article on The Operative Treatment of Fractures, inthe Journal of the American Medical Association of January 13th and 20th,1906, Dr. James A. Kelly, of Philadelphia, goes very fully into the subject inits relation to all varieties of fractures, including recent open and closed, as wellas ununited and other fractures. As to the closed fractures most suitablefor this method of treatment he says.: While it is not advisable or necessary to operate on all closed fractures, yetthere are certain bones which, when fractured, generally demand operative inter-ference if we would obtain the best anatomic and functional results. Many authori-. Fig. 20.—Peters Forceps. (From Cheyne and Burghard.) As shown in the diagram, the frag-ments can be held firmly in apposition by this instrument while the bone is being drilled. These forcepsare provided with an extra blade which can be made to replace the one shown at the right in the fig-ure. The one here represented is the larger, and is employed when screws are to be used; the smallerone is designed for use when wires are to be inserted. ties still maintain that no closed fracture should be converted into an open one,but there are some fractures in which even the most conservative surgeons willadmit that, were it not for the danger of sepsis intervening, better functional resultscould be obtained by operation. Among such may bs mentioned the following:(1) Fractures of the neck of the femur in patients under 50 years; (2) fractures ofthe femur; (3) fractures of the patella; (4) oblique fractures
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