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A treatise on orthopedic surgery . d is placed face downward ona table, the feet projecting over its end. The body of the 430 OBTEOPEDIC SUEGEBY. patient is then elevated by means of pillows to conform to thedeformity—that is, the thigh is raised sufficiently to permit thetibia to lie evenly upon the anterior border on the table. Theoperator then holds the head of the tibia firmly against thetable while the assistant exerts intermittent and gradually in-creasing downward pressure on the thigh, but never to theextent to lift the tibia from the table; thus, further subluxationis impossible. As t
A treatise on orthopedic surgery . d is placed face downward ona table, the feet projecting over its end. The body of the 430 OBTEOPEDIC SUEGEBY. patient is then elevated by means of pillows to conform to thedeformity—that is, the thigh is raised sufficiently to permit thetibia to lie evenly upon the anterior border on the table. Theoperator then holds the head of the tibia firmly against thetable while the assistant exerts intermittent and gradually in-creasing downward pressure on the thigh, but never to theextent to lift the tibia from the table; thus, further subluxationis impossible. As the contraction gives way the pillows areremoved. Usually the deformity may be reduced at one sitting,but if it is very resistant complete correction is not the conclusion of the operation adhesive plaster straps fortraction and a close-fitting plaster bandage are applied (). Rest in bed with traction is enforced for a time, and the ordi-nary brace is then applied. This is, in the authors experience, Fig. The authors method of correcting flexion deformity at the knee by reverseleverage. The folded sheet indicates the degree of subluxation present. Inresistant cases of this type an assistant applies the pressure on the thigh. the most effective and satisfactory method for reducing de-formity. If the contraction is of long standing preliminaryopen division of the flexor tendons is advisable. The deformityis then in part corrected, complete rectification being deferreduntil repair is complete. The Billroth Splint.—The Billroth splint, as modified by Still-man, IS an effective appliance for overcoming resistant de-formity. A thick pad of felt is placed over the upper surfaceof the condyles of the femur and a thinner pad in the poplitealregion over the upper border of the tibia. Other points thatmay be subjected to pressure are similarly protected, especiallythe dorsum of the foot and the perineum. A plaster bandage is TUBERCULOUS DISEASE OF THE KNEE-JOI
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910