A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . e of the fresh surfaces of bone is proper,if the lameness is annoying. Fractures of the patella have been treated satisfactorily by othermethods, which deal with the fragments more directly than the hooks or adhesive plaster. The methodof passing a silk suture horizon-tally around the two fragments,by means of a long needle thrustthrough the skin and muscles,and tying the fragments togetherseems likely to give good resultsand do
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . e of the fresh surfaces of bone is proper,if the lameness is annoying. Fractures of the patella have been treated satisfactorily by othermethods, which deal with the fragments more directly than the hooks or adhesive plaster. The methodof passing a silk suture horizon-tally around the two fragments,by means of a long needle thrustthrough the skin and muscles,and tying the fragments togetherseems likely to give good resultsand does not invade the method passes a similarsuture vertically around the twofragments and ties them suture traverses the jointimmediately below the operations, especially thelatter, make separation of thepieces of the patella almost im-possible and restraint in the ex-tended position of the joint need Barkers operation for transverse fracture of the UOt be maintained for more than patella hj means of a ligature passed around the j.„,„ , j_i,„„„ „ „„i „ bone. (KeeI and white.) two or three weeks. Fig. Fractures of the Tibia and Fibula. The tibia and fibula are each developed by three ossific centers, onefor the shaft and one for each extremity. The upper epiphyses uniteat about twenty five years of age, the lower at about twenty the tubercle and malleolus of the tibia develop from sep- FRACTURES OF THE TIBIA AND FIBULA. 473 arate centers. The possibility of epiphyseal separations occurring whenthe bones of the legs are subjected to violence should be diastases are, however, very rare. Fractures Near the Knee.—Fractures at the upper end of the tibia,which usually are accompanied by fibular fracture, are frequently trans-verse and may, by more or less vertical lines, invade the knee the fibula is neither broken nor dislocated, it aids in preventingdisplacement. Epiphyseal
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