American practice of surgery : a complete system of the science and art of surgery . 225 Brainard, of Chicago. Until recent years it was very much practised, but withthe development of modern antiseptic technique it has largely passed out ofuse. It has the advantage of avoiding a cutting operation, and in rare casesmay be serviceable at the present The method of procedure is as fol-lows : the skin is perforated with the instrument or a narrow-bladed bistoury,and an opening made to the seat of fracture. A special perforator is thenintroduced along the track of this opening, and is made t
American practice of surgery : a complete system of the science and art of surgery . 225 Brainard, of Chicago. Until recent years it was very much practised, but withthe development of modern antiseptic technique it has largely passed out ofuse. It has the advantage of avoiding a cutting operation, and in rare casesmay be serviceable at the present The method of procedure is as fol-lows : the skin is perforated with the instrument or a narrow-bladed bistoury,and an opening made to the seat of fracture. A special perforator is thenintroduced along the track of this opening, and is made to pass through bothfragments and the line of fracture at several points, without removing the drillfrom the wound in the soft tissues. The number of bone perforations will de-pend on the size of the bone fractured. A drill with a triangular point is con-sidered preferable to one with a flat point, as it is less liable to break or tosplit the bone. This accident occurred in a case reported by Weir, in conse-quence of which severe infection followed and the patient died. Brainard,. Fig. 110.—Fixation of the Overriding Fragments by Two Ivory Pegs. (Von Bruns.) from his experience, considered that, generally, two or three bone perfora-tions were sufficient for the first attempt. Where no foreign body intervenedand the fragments were closely apposed, the method was said to be usuallysuccessful, although a repetition was often demanded. Dieffenbach becamedissatisfied with this method and added the introduction of ivory pegs throughthe bone perforations (see Fig. 110). As ordinarily performed this operationwill not provide for the removal of intervening foreign tissues nor for freshen-ing the ends of the fragments. The wound that is necessary is quite oralmost as dangerous, with careful antisepsis, as one large enough to exposethe fragments freely, so that there is little reason for preferring it to the modernoperation of resection. White says that these methods of drilling and pinn
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