Modern surgery, general and operative . ^ soft that none of these appliances will secure fixation. Freeman has de\dsed a clamp for this purpose (Figs. 431, 432). An addi-tional incision is made over the trochanter and holes are bored for the clamp 694 Diseases and Injuries of the Bones and Joints screws, one hole being drilled through the base of the trochanter, the exter-nal fragment of the neck, and into the head of the bone (Annals of Sur-gery, Oct., 1904). The wound is closed, dressings are applied, and extensionis made on a long side splint, a pad being placed beneath the trochanter topre
Modern surgery, general and operative . ^ soft that none of these appliances will secure fixation. Freeman has de\dsed a clamp for this purpose (Figs. 431, 432). An addi-tional incision is made over the trochanter and holes are bored for the clamp 694 Diseases and Injuries of the Bones and Joints screws, one hole being drilled through the base of the trochanter, the exter-nal fragment of the neck, and into the head of the bone (Annals of Sur-gery, Oct., 1904). The wound is closed, dressings are applied, and extensionis made on a long side splint, a pad being placed beneath the trochanter toprevent the disposition to pass backward, which movement, if it occurs, will. Fig. 432.—Completed screw and clamp of Freemans apparatus for fixation of fracture of neck of femur(Freeman, in Annals of Surgery, Oct., igo4). cause external rotation of the limb and separation of the fragments. In abouteight weeks the extension is removed and the patient is allowed about oncrutches. Dr. H. Augustus Wilson has succeeded by simply nailing thefragments together without attempting to freshen their faces. He got his patient up on crutches in two weeks ( Orthopedic Surgery, Jan., 1908). In Freemans case the screws were removedin two weeks because of infection of the cancel-lous tissue. A similar condition arose in Davisscase, in which two steel drills were used. Dr. Wilson has collected 36 cases of directfixation of old intracapsular fractures (Ibid.). Ununited Fracture of Patella.—A semilunar in-cision is made about the fragments, the convexitypointing up or down (this avoids the prepatellarbursa), or an incision is made in the long axis ofthe li
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