Studies from the laboratories of the Deptof Surgery . Jul\ .30, 1919; oijcration per-formed June 22, 1919, consisting of removal of 2 inches (5 cm.) of anteriorsurface of the upper third of the tihia: A, area of bone removed at primaryoperation; hi, involucrum ; .S, separation zone. The treatment of acute in children may jjrtjperly bedivided into the treatment at the acute, and treatment at the subacute,stage. The i>rimary indication for operation at the onset is the relief ofpus under pressure, and ns surh, if requires the application of the 25 same surgical principles as p
Studies from the laboratories of the Deptof Surgery . Jul\ .30, 1919; oijcration per-formed June 22, 1919, consisting of removal of 2 inches (5 cm.) of anteriorsurface of the upper third of the tihia: A, area of bone removed at primaryoperation; hi, involucrum ; .S, separation zone. The treatment of acute in children may jjrtjperly bedivided into the treatment at the acute, and treatment at the subacute,stage. The i>rimary indication for operation at the onset is the relief ofpus under pressure, and ns surh, if requires the application of the 25 same surgical principles as pus collections elsewhere in the body, thatis, adequate drainage, with the least possible trauma and with carefulattention to the blood supply. If one considers that frequently peri-osteum with its blood supply has been stripped from the shaft by theexudation of pus and that the only remaining blood supply to the shaftis through the nutrient artery, one realizes the danger to the entireshaft of too active treatment by curettage or packing (Fig. 10).. Fig. 24 (Case 1).—Operation, June 11. 1919; roentgenojram taken ., 1919: S, former separation zone; marked subperiosteal proliferation. Nooperative procedure has been performed on this area. It is true that in the region of the metaphysis, the bony septumssomewhat reseinble the septums of the mastoid, and that, therefore,in this region it may be necessary to break up the compartments ofthe abscess. Care should be taken even here not to traumatize anymore than possible. 26 Constant, careful postoperative observation of these cases is neces-sar\-, as there are frequent secondary metastatic abscesses in the softparts. Subacute Stage.—Before the days of wound sieriHzation, tlie courseof a case could be fairly detinitely prophesied. At the primary opera-tion, the shaft was opened wide, frequently curetted and this, sequestration occurred, freciuently involvino ahnost theentire shaft. As advised by Nichols, of B
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishernewyork, bookyear19
