A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . s very great intra-articular effusion, aspirationof the joint with an aseptic aspiration needle should be small size and irregular margins of the fragments, their beingimbedded in a tendinous aponeurosis which is attached to the boneat the anterior edge of its margins and the convex surface of thecondyles on which the fragments rest all make accurate adjustment byencircling dressings difficult and unsatisfactory. T
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . s very great intra-articular effusion, aspirationof the joint with an aseptic aspiration needle should be small size and irregular margins of the fragments, their beingimbedded in a tendinous aponeurosis which is attached to the boneat the anterior edge of its margins and the convex surface of thecondyles on which the fragments rest all make accurate adjustment byencircling dressings difficult and unsatisfactory. The best treatmentfor the majority of cases is obtained by drawing the fragments togetherby means of steel hooks thrust through the skin and imbedded in thetendon above and below the upper and lower fragments hooks devised by Malffaig-ne are effective, but on account of theirregular shape of the bone do not permit as accurate coaptation as dothose devised by Levis. These latter are separated pairs and can,therefore, be introduced parallel to each other or at an angle, varyingwith the line of fracture and tendency to irregularity in the displace-. Uminited fracture of patella showinging flexion. displacement dur- 470 FRACTURES. nient. Each pair of hooks has its points held together, after coaptationof the fragments, by a screw or by a lateral clamp. To lessen the muscular cause of displacement the leg should be keptfully extended on the thigh and the thigh perhaps slightly flexed onthe pelvis. This is readily done by elevating the limb on an inclinedplane, or by supporting it with pillows after placing any form of rigid Fig. 244.
Size: 1223px × 2044px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, booksub, booksubjectsurgicalproceduresoperative
