Preparatory and after treatment in operative cases . il seven weeks after the operation, and at firstthe patella should be steadied as the leg is cautiously and carefullybent. As a rule, no attempt to obtain complete flexion of thejoint should be attempted until after the expiration of twelveweeks after the operation. In the meantime the limb should be UNION OF FRACTURED BONES 633 massaged daily. If infection of the joint occurs, the cast mustbe cut down, the wound completely opened, drainage establishedand the joint treated as infected joints are taken care of fromother causes. UNION OF FRACT
Preparatory and after treatment in operative cases . il seven weeks after the operation, and at firstthe patella should be steadied as the leg is cautiously and carefullybent. As a rule, no attempt to obtain complete flexion of thejoint should be attempted until after the expiration of twelveweeks after the operation. In the meantime the limb should be UNION OF FRACTURED BONES 633 massaged daily. If infection of the joint occurs, the cast mustbe cut down, the wound completely opened, drainage establishedand the joint treated as infected joints are taken care of fromother causes. UNION OF FRACTURED BONES The union of fractured bones by holding in apposition thefragments by means of wire, nails, pegs or similar device is fol-lowed by drainage in most instances. The use of the drainage isgoverned by much the same rules which are applicable to woundsgenerally, except, perhaps, that in this class of cases the oozingof blood from the traumatized bone may be regarded as a specialindication for its use. After the protective dressing is applied,. Fig. 426.—ParkhiUs Screws in situ. (Bryant.) the bone and contiguous joints are immobilized in plaster-of-Paris, and on the third day following the operation the drain isremoved through a small window cut into the cast for the pur-pose. On the tenth day after the operation the window in thecast is enlarged and the sutures removed from the wound. Thewound is then dressed, and in most instances need not be dis-turbed until the cast is cut down for some other purpose. Ifthere be a superficial infection, the dressing is changed every twodays until healing takes place. In instances where long bones,such as the tibia cannot be held in proper apposition, a deviseemployed by ParTchill is frequently introduced into the frag- 634 MISCELLANEOUS OPERATIONS ments. When the device is in situ it presents the conditionsshown in Fig. 426. This method of treatment renders the appli-cation of a plaster cast a trifle more complicated, as the instru-m
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