A treatise on orthopedic surgery . , together with theadjoining upper border of the acetabulum, is then cut away and 394 OETHOPEDIC SUEGEBY. the neck of the femur is separated from the shaft with a sawor chisel. All the diseased parts are then removed, includingthe acetabular wall and adjoining bone, if necessary. Thewound is partly closed with drainage, and the extremity of thefemur is placed within the acetabulum, where it should beretained for a time by a plaster bandage or Thomas brace pro-vided with traction straps. When the patient begins to walk ahip splint or other support is used for
A treatise on orthopedic surgery . , together with theadjoining upper border of the acetabulum, is then cut away and 394 OETHOPEDIC SUEGEBY. the neck of the femur is separated from the shaft with a sawor chisel. All the diseased parts are then removed, includingthe acetabular wall and adjoining bone, if necessary. Thewound is partly closed with drainage, and the extremity of thefemur is placed within the acetabulum, where it should beretained for a time by a plaster bandage or Thomas brace pro-vided with traction straps. When the patient begins to walk ahip splint or other support is used for a time to prevent de-formity. One of the most efficient supports of this class is theshort spica, the limb being fixed in an attitude of overextensionand moderate abduction for many months with the aim of ob-taining bony or fibrous anchylosis. Another form of incision is that of Rydygier^ shown in theaccompanying illustration. The flap is lifted, the trochantermajor is cut through and with its attached muscles turned up- FiG. Rydygiers incision for excision of the hip. ward. The capsule is then opened and the femur is dislocatedfor inspection. All the diseased parts, including the entireacetabulum, if necessary, together with the capsule, are thenremoved. Complete removal of the acetabulum is indicatedwhen it is perforated, a procedure particularly advocated byBardenheuer. The success or failure of excision of the hip as a life-savingoperation, provided the diseased bone has been removed, is de-^ Mosetig-Moorhof, Wiener klin. Wochen., No. 20, 1905. TUBEBCULOUS DISEASE OF THE EIP-JOINT. 395 cided bj the after-treatment, and in this, drainage is the firstessential. The opening must be large and the shaft of-the bonemust be drawn down by efficient traction, so that it may notobstruct the opening, and the exuberant granulations must beremoved from time to time. Short glass drainage tubes ofdiameter up to one and one-half inches as suggested by Phelpsmay be used with advantage
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
