. Minor and operative surgery, including bandaging . young persons, care should betaken to remove only so much bone as may be donewithout encroaching upon the lines of epiphyseal carti-lages, as removal of the epiphyseal cartilage would inter-fere with the subsequent growth of the bones. Arthrectomy of the Knee-joint.—This operation isemployed as a substitute for the operation of excision indisease of the knee-joint, and is performed by exposingthe joint by an incision similar to that employed in excis-ion. The ligamentum patellae is divided and the patella 550 EXCISIONS OR RESECTIONS. is refl
. Minor and operative surgery, including bandaging . young persons, care should betaken to remove only so much bone as may be donewithout encroaching upon the lines of epiphyseal carti-lages, as removal of the epiphyseal cartilage would inter-fere with the subsequent growth of the bones. Arthrectomy of the Knee-joint.—This operation isemployed as a substitute for the operation of excision indisease of the knee-joint, and is performed by exposingthe joint by an incision similar to that employed in excis-ion. The ligamentum patellae is divided and the patella 550 EXCISIONS OR RESECTIONS. is reflected with the skin flap. When the joint has beenfreely exposed, the diseased articular cartilages, semilunarcartilages, crucial ligaments, and synovial pouches areremoved by the use of the knife or scissors and thecurette; if the surface of the bone is found to be carious,it is removed by the curette or gouge. After the jointhas been thoroughly cleared of diseased tissue it is irri-gated, the divided ligamentum patellse is sutured with Fig. Resection of lower end of the fibula. several strands of chromicized catgut or silk, and thewound is drained and closed. Excision of the Patella.—The patella may be excisedby making a longitudinal or crucial incision ; the perios-teum is carefully separated from the bone, and the latteris grasped with strong forceps and dissected free from itsattachments upon the under surface. The knee-joint isgenerally opened in removing the patella, unless removalof the bone be undertaken for necrosis or caries, when it EXCISION OF THE ANKLE-JOINT. 551 is possible to accomplish its complete removal withoutopening the joint. Resection of the Tibia or Fibula.—In resecting thetibia or fibula, the bones may be exposed by a longitudinalincision over the bone to be removed, and after the shaftof the bone has been exposed and the periosteum separatedas completely as possible, the shaftof the bone may be divided at its Fig. 462. middle, and each frag
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