. Modern surgery, general and operative. lamp for this purpose (Figs. 489, 490). An addi-tional incision is made over the trochanter and holes are bored for the clampscrews, one hole being drilled through the base of the trochanter, the exter-nal fragment of the neck, and into the head of the bone (Annals of Sur-gery, Oct., 1904). The wound is closed, dressings are applied, and extensionis made on a long side splint, a pad being placed beneath the trochanter toprevent the disposition to pass backward, as this movement, if it occurs, willcause external rotation of the limb and separation of the
. Modern surgery, general and operative. lamp for this purpose (Figs. 489, 490). An addi-tional incision is made over the trochanter and holes are bored for the clampscrews, one hole being drilled through the base of the trochanter, the exter-nal fragment of the neck, and into the head of the bone (Annals of Sur-gery, Oct., 1904). The wound is closed, dressings are applied, and extensionis made on a long side splint, a pad being placed beneath the trochanter toprevent the disposition to pass backward, as this movement, if it occurs, willcause external rotation of the limb and separation of the fragments. In about 784 Diseases and Injuries of the Bones and Joints eight weeks the extension is removed and the patient is allowed about oncrutches. Dr. H. Augustus Wilson has succeeded by simply nailing the frag-ments together without attempting to freshen their faces. He got his patientup on crutches in two weeks (Amer. Jour. Orthopedic Surgery, Jan., 1908).Tn Freemans case the screws were removed in two weeks because of infection. Fig. 490.—Completed screw and clamp of Freemans apparatus for fixation of fracture ofneck of femur (Freeman, in Annals of Surgery, Oct., 1904). of the cancellous tissue. A similar condition arose in Daviss case, in whichtwo steel drills were used. Dr. H. Augustus Wilson has collected 36 cases ofdirect fixation of old intracapsular fractures (Ibid.). Ununited Fracture of Patella.—Ten days before operating inject the knee-joint with 15 of a 2 per cent, solution of formalin in glycerin. This will produce a chemical inflammatory reaction, whichcoffer-dams the lymph spaces and strengthens im-munity to infection (John B. Murphy, in hisSurgical Clinics, Vol. iv). A semilunar incisionis made about the fragments, the convexity point-ing up or down (this avoids the prepatellar bursa),or an incision is made in the long axis of the limb,over the middle of the space between the frag-ments, from well above the upper fragments to wellbelow the lower
Size: 2112px × 1183px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidmodernsurger, bookyear1919
