Lectures on orthopedic surgery . o impossible. Aspiration, followed by the injection of antisepticfluids, has been abandoned, as also has the injection oliodoform-ether; but the injection of iodoform-emul-sion (10% mixture of iodoform in olive-oil or glycerin)still finds favor with some general surgeons, and, intheir hands, is reported to yield good results. Theresults, however, are less favorable with the large,tortuous and deeply-seated abscesses of spondylitis thanwith those at other joints. We have long since aban- 105 doned the use of this method of treatment, as alwaysuseless and at time
Lectures on orthopedic surgery . o impossible. Aspiration, followed by the injection of antisepticfluids, has been abandoned, as also has the injection oliodoform-ether; but the injection of iodoform-emul-sion (10% mixture of iodoform in olive-oil or glycerin)still finds favor with some general surgeons, and, intheir hands, is reported to yield good results. Theresults, however, are less favorable with the large,tortuous and deeply-seated abscesses of spondylitis thanwith those at other joints. We have long since aban- 105 doned the use of this method of treatment, as alwaysuseless and at times harmful. Incision of an abscess is demanded when the patientsuffers from septic symptoms, when the location of theabscess is such as to prevent effective mechanicalrestraint to the diseased area, and when the abscessthreatens important structures. Incision for the reliefof such an abscess may have to be made almost any-where. In cervical disease, behind the sterno-mastoidmuscle; in dorsal disease, by the side of the vertebrse;. Fig. 70.—Diagrammatic section through the middle of the neck, showing theattachment of the pre-vertebral fascia laterally to the carotid sheath, thus direct-ing pus into the posterior triangle of the neck in cervical caries. The fascia isattached above to the base of the skull; below it becomes lost in the posteriormediastinum centrally, and passing over the brachial plexus at the root of theneck in front of the subclavian artery to be attached to the costocoracoid mem-brane. If pus descends, it may find its way into the axilla or the posterior medi-astinum, in addition to pointing in the pharynx and the posterior triangle ofthe neck. in lumbar disease, just outside the erector spinse, andin the case of psoas-abscess resulting from disease inany part of the spinal column, an opening may have tobe made above or below Pouparts ligament, or evenattack made from the lumbar region. The accompany-ing diagram shows the arrangement of the pre-vertebralfascia
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
