. On modern methods of treating fractures . Fig. 124.—Malleolar fracture with marked displacement. Supramalleolar Fractures.—These fractures not only dis-organize the ankle-joint, but they are liable to produce adhesionsof the tendons running in front of the bones. The lower endsof the tibia and fibula are spongy bones which ^^^ll not holdscrews. Accurate reduction is often very difficult. Operation.—Double lateral incisions are required, but shouldbe curved, with convexity forwards, so that the sutured wounds 248 MODERN METHODS OF TREATING FRACTURES will not lie over the line of the ])lates.
. On modern methods of treating fractures . Fig. 124.—Malleolar fracture with marked displacement. Supramalleolar Fractures.—These fractures not only dis-organize the ankle-joint, but they are liable to produce adhesionsof the tendons running in front of the bones. The lower endsof the tibia and fibula are spongy bones which ^^^ll not holdscrews. Accurate reduction is often very difficult. Operation.—Double lateral incisions are required, but shouldbe curved, with convexity forwards, so that the sutured wounds 248 MODERN METHODS OF TREATING FRACTURES will not lie over the line of the ])lates. The lower ends of thetibia and fibula are first adjusted aecurately to one another inthose cases where they have been torn apart. Then the bonesare transfixed. It is safe to take a point 1 ineh above the tipof the internal malleolus and towards the back of the innersurface of the tibia. This will avoid anv danijer of enteringf the. Fig. 125.—The same as Fig. 124, after the apphcation of bolted patient was a woman weighing 18 stone, and she had good anklemovement six months later, being able to stand on tij3-toe. ankle-joint. A corresponding point is taken on the outer sideof the fibula. Each of these points is marked with a broad drill,the bones are clamped together with the elamp drill-guide, andthe bones pierced. A long bolt is used through the proper holeof a pair of plates, and nuts are screwed on, leaving the ends forthe attachment of traction handles. By these the distal frag-ments are pulled down into proper position, the plates are then OPERATIVE TREATMENT OF SPECIAL FRACTURES 249 bent into shape, and fixed by the screws which are threaded inthe plate. In this fixation the bolt holds the plates and fixesthe lower fragments together, whilst the short screws serve tokeep the distal fragments in j^roper position in relation to theshafts {Figs. 124, 125). There are certain cases of comminuted fr
Size: 1179px × 2118px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bo, bookcentury1900, bookdecade1910, bookidonmodernmethodso00grov
