American practice of surgery : a complete system of the science and art of surgery . agments accurately, and in fittingthem together found it practically impossible to prevent lateral sliding of onefragment on the other, the side of one fragment falling into the central concavityof the other. In oblique fractures of the tibia, after the removal of the inter-vening fibrous tissue and freshening of the fractured surfaces by the curette andchisel, the writer has several times observed the fragments very firmly held to-gether by gimlets (see Fig. 113). The whole lower extremity could be lifted by
American practice of surgery : a complete system of the science and art of surgery . agments accurately, and in fittingthem together found it practically impossible to prevent lateral sliding of onefragment on the other, the side of one fragment falling into the central concavityof the other. In oblique fractures of the tibia, after the removal of the inter-vening fibrous tissue and freshening of the fractured surfaces by the curette andchisel, the writer has several times observed the fragments very firmly held to-gether by gimlets (see Fig. 113). The whole lower extremity could be lifted by the PSEUDARTHROSIS. 229 heel, with absolutely no movement between the fragments, and later during thedressings without discomfort to the patient. This degree of fixation is main-tained for a week or two, after which the softening which takes place about thegimlets renders such manipulations inadvisable. The gimlets, of course, pro-truded from the wound, which was closely sutured about them, permittinghealing by first intention, except for the small openings left after the removal. Fig. 113.—Ununited Fracture of Both Bones of the Leg, with a Single Gimlet Giving Good Fixation. (Skiagraphed by Dr. II. K. Pancoast.) of the gimlets. Firm union resulted in every case, and usually little or no in-fection. The wire suture could not produce the same degree of fixation, norcould the gimlets in a transverse fracture. In 1S92 J. William White employed in a case of pseudarthrosis of the hu-merus, a metallic plate an inch wide, with four holes, two for each apertures in the plate were so arranged that the two for each fragmentwere three-eighths of an inch apart, and the inner one a half inch from the line of 230 AMERICAN PRACTICE OF SURGERY.
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
