. Manual of operative surgery. The opinions ofsurgeons vary much as to operative interference. Cheyne and Burghard recom-mend operation almost as routine in T-fractures. Of course when there isgrave injury to the nerves (usually the musculo-spiral and median) or to thevessels about the elbow and this is not relieved by reposition of the fragmentsof bone, operation is imperative. 936 SPECIAL FRACTURES When operating, if it is possible to avoid opening the elbow-joint, do 1128 shows the limits of the joint. The time of choice for operationis during the second week after injury. After o
. Manual of operative surgery. The opinions ofsurgeons vary much as to operative interference. Cheyne and Burghard recom-mend operation almost as routine in T-fractures. Of course when there isgrave injury to the nerves (usually the musculo-spiral and median) or to thevessels about the elbow and this is not relieved by reposition of the fragmentsof bone, operation is imperative. 936 SPECIAL FRACTURES When operating, if it is possible to avoid opening the elbow-joint, do 1128 shows the limits of the joint. The time of choice for operationis during the second week after injury. After operation passive movementsought to be begun in about fourteen days or even less. Methods of Operating.—(A) Fracture of one condyle. Step I.—Reflect a skin flap, convexity forwards, from over the fracturedcondyle (Cheyne and Burghard). Step 2.—Flex the elbow. Separate the soft parts from the upper part ofthe condyle until there is sufiicient exposure. Remove interposed tissues andwash the joint cavity with salt Radial cul de 1128.—[Poirier ei Charpy.) Step 3.—Reduce the fracture and fix it in position by peg, nail, or any important structures which may have been torn or divided. Step 4.—Close the wound. Dress. Put up in the acutely flexed splint is necessary or desirable. (B) Fracture of Both Condyles. T-shaped Fracture. Step I.—^Method A.—Make a longitudinal lateral incision over each con-dyle and exposg the fracture. Do not jeopardize the nutrition of the condyleby unnecessary separation of the soft parts. Method B.—Make a vertical median incision over the olecranon processas in excision of the elbow. Split the triceps tendon vertically. With theperiosteal elevator separate the tendon from the ulna and so reach the fracturewithout peeling the condyle out of its attached soft parts. Step 2.—Reduce the fracture. Peg the two condyles together or to theshaft of the humerus. If incision B has been used, it is well af
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