. Manual of operative surgery. Coronary ligament Transverse ligamentAnterior crucial ligament Coronary ligamentInternal semilunar fibro-cartilage Fig. i286.—iDeaver.) Figure 1286 will remind the reader of the anatomy of the knee. Figure 1287 shows fracture of the tibial spine in which the chief symptoms ARTHRECTOMY 1039 were tenderness, swelling and undue lateral mobility. Hayden treated the caseby immobilizing with plaster of Paris and obtained a perfect result about 79 daysafter the injury was received. Repair of Ruptured Lateral Ligaments.—When the lateral ligaments of theknee are ruptured
. Manual of operative surgery. Coronary ligament Transverse ligamentAnterior crucial ligament Coronary ligamentInternal semilunar fibro-cartilage Fig. i286.—iDeaver.) Figure 1286 will remind the reader of the anatomy of the knee. Figure 1287 shows fracture of the tibial spine in which the chief symptoms ARTHRECTOMY 1039 were tenderness, swelling and undue lateral mobility. Hayden treated the caseby immobilizing with plaster of Paris and obtained a perfect result about 79 daysafter the injury was received. Repair of Ruptured Lateral Ligaments.—When the lateral ligaments of theknee are ruptured they may be exposed and sutured but earlier use and bettermotion and strength may be expected from the following procedure reported byE. Lexer (Archiv f. klin. Chir., xcviii, 819). Expose the injured parts by afree incision. Suture any wound of the joint capsule. From the tendon of therectus femoris obtain a non-pedunculated (unattached) flap of suitable length. Fig. 1287.—{Hayden.) and thickness. Suture the flap to the femur above and the tibia below. Ifmere suturing of the flap to the periosteum seems insecure, reflect a flap of perios-teum, cut a groove in the bone, place the end of the flap into the groove, fix itthere with a staple and cover with the periosteal flap. Arthrectomy.—^Excision.—The term arthrectomy is here used as meaningthe removal of synovialis either alone or plus excision of the diseased portions ofcartilage and bone. The term excision is reserved for operations where the wholearticular surfaces are formally excised. Method A.—^Lateral Incision.—5/e/> i.^—Beginning at the inner side of theligamentum patellae, make a curved incision upwards and backwards to theanterior margin of the internal lateral ligament where it crosses the line of thearticulation; continue the cut upwards over the internal epicondyle and make itcurve forwards and upwards around the inner and upper part of the superior I040 KNEE-JOINT
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