A manual of operative surgery . HUMERUS. [Modified from Farabeuf.) of the bone so fixed, and the excision of the humerus is saw-line generally crosses the bone at right angles to itslong axis, and just below the tips of the condyles. In using thesaw a metal retractor or spatula should be employed to holdback and retract the soft parts. A strip of bent metalof the form shown in Fig. 469 answers admirably for thispurpose. CHAP. IV] EXCISION OF THE ELBOW 743 Sawing Off of the Ends of the Radius and Ulna.—Whilethe limb is in the same position the assistant who is fixing theforearm re
A manual of operative surgery . HUMERUS. [Modified from Farabeuf.) of the bone so fixed, and the excision of the humerus is saw-line generally crosses the bone at right angles to itslong axis, and just below the tips of the condyles. In using thesaw a metal retractor or spatula should be employed to holdback and retract the soft parts. A strip of bent metalof the form shown in Fig. 469 answers admirably for thispurpose. CHAP. IV] EXCISION OF THE ELBOW 743 Sawing Off of the Ends of the Radius and Ulna.—Whilethe limb is in the same position the assistant who is fixing theforearm relaxes his hold, and, forcing the bones of that partof the limb upwards, makes them in turn protrude prominentlyin the wound. The ulna is grasped with the lion forceps, whichare again held vertically, as if to draw the bone directly upwards ;and the metal spatula having been applied, the saw is usedhorizontally upon the base of the process, a slice of the upperend of the radius being removed at the same time (Fig. 463). iMife. -FRONT AND BACK VIEWS OF HUMERUS. FIG. 470. The line e. /. indicates the usual level of the saw-cut in excision of the joint. The section mayrequire to be made higher up in some cases. The wound is washed out, is adjusted with sutures, and adrainage-tube is inserted. After-treatment.—After the operation the limb must beplaced upon a suitable splint, and the bones so adjusted thatthe greater diameters of the bony surfaces correspond and donot cross. The hand should be in the mid-position betweenpronation and supination, and the elbow be very slightly bent—so slightly that the forearm will be nearer to the extendedposture than to the position it occupies when at right angles tothe arm. The precise angle recommended by most surgeonsis one of 1350. Very many forms of splint have been devised. The mainrequirements of such appliances are that they be light, strong,rigid, easily kept clean, and do not interfere with the drainage 744 OPERATIONS ON BONES AND
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