. The principles and practice of surgery. opening usually asI have recommended in frac-tures ; and the single verticalincision, made along the centreof the dorsal aspect of the limb,will suffice. We must againlimit ourselves to the removalof only that which is diseased,and, as far as practicable, pre-serve the attachments of mus-cles ; but if it becomes necessaryto remove any portion of theshaft of the ulna, an equal portion of the radius must be removed also,to preserve the balance and symmetry of the joint. A removal of thehead of the radius does not so imperatively demand excision of theuln
. The principles and practice of surgery. opening usually asI have recommended in frac-tures ; and the single verticalincision, made along the centreof the dorsal aspect of the limb,will suffice. We must againlimit ourselves to the removalof only that which is diseased,and, as far as practicable, pre-serve the attachments of mus-cles ; but if it becomes necessaryto remove any portion of theshaft of the ulna, an equal portion of the radius must be removed also,to preserve the balance and symmetry of the joint. A removal of thehead of the radius does not so imperatively demand excision of theulna. Finally, both excision and simple division of the bone is sometimespractised at this joint for the relief of bony anchylosis. In case the elbow is bent at a right angle, and it is proposed to givemotion, a V-shaped piece must be removed at a point correspondingto the articulation, the base of which is posterior; but if the arm isanchylosed in a straight position, simple transverse section of the bonewith a saw is sufficient. Fig. Excision of Elbow-joint by Single Incision. EXCISIONS OF HUMERUS. 391 J. Rhea Barton, of Philadelphia, was the first to perform excisionfor anchylosis; the operation having been made on a physicianhaving angular anchylosis of the knee-joint, on the 27th of May, was the first also to practise simple division of the bone for anchy-losis. In this latter case the anchylosis was at the hip-joint, and theoperation was made in 1827. Results of Excision at the Elbow-joint.—Partial returns from theSuro-eon-Generals office at Washington, give 315 cases of excision atthe elbow-joint, and in 286 cases the results are ascertained; 62 termi-nated fatally, and of the remainder, 16 subsequently required amputa-tion. A fraction less than one-third were, therefore, unsuccessful; andthe mortality was per cent. In order to form a correct estimateof the value of this operation, it must be considered in the light of analternative, or of a substitut
Size: 2039px × 1225px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1870, booksubjectg, booksubjectsurgery
