. Manual of operative surgery. 1186. Fig. 1185. Fig. 1186. -Macewens linear supracondyloid osteotomy, kept parallel to the long axis of the thigh until it comes in contact with the bonewhen it is to be turned transversely to the bone. Drive the osteotome throughthe cortical bone until so much is divided that the remainder is easily rest of the treatment is the same as in Method A. Inspection of Figs. 1184, 1185, 1186, shows that theoretically Macewensoperation is the better, but it must be admitted that a clean osteotomy givesgood results whether performed from the inner or the o
. Manual of operative surgery. 1186. Fig. 1185. Fig. 1186. -Macewens linear supracondyloid osteotomy, kept parallel to the long axis of the thigh until it comes in contact with the bonewhen it is to be turned transversely to the bone. Drive the osteotome throughthe cortical bone until so much is divided that the remainder is easily rest of the treatment is the same as in Method A. Inspection of Figs. 1184, 1185, 1186, shows that theoretically Macewensoperation is the better, but it must be admitted that a clean osteotomy givesgood results whether performed from the inner or the outer side. 970 OSTEOTOMY (C) Ogstons operation: Osteo-arthrotomy. Jhis, the lirst successfuloperation for knock-knee (1876), is directed against the real or supposed length-ening of the internal condyle. Step I.—Flex the knee as fully as possible. Introduce a narrow-bladedknife or elongated tenotome (Adamss knife) through the skin at a point 2 or 3inches above the tip of the inner condyle. Push the knife downwards, forwards. Fig. 1187.—{Hofa.) Annandale; b, Ogston; c Reeves; d. Macewens cuneiform osteotomy; e. Chiene; / Macewenssupracondyloid; g. Reeves; h. Billroth; ». Mayer; k, Schede; /, Barwell. and outwards until the point is felt in the intercondyloid space. Turn the edgeof the knife towards the bone and in withdrawing it cut the soft structures to thebone. Step 2.—Introduce an Adamss saw through the knife wound and divide theinternal condyle from above downwards for three-fourths of its thickness. Com-plete the fracture by straightening the limb, when the loosened condyle willslip upward (Fig. 1187). OSTEOCLASIS 971 Step 3.—Immobilize and treat as a fracture. {D) Reeves operation is similar to Ogstons but in it the bone section ismade with a chisel down to but not through the articular cartilage, thus avoidingany direct opening of the joint. Fowler and Pilcher long ago showed that thisoperation has nothing to recommend it. (jE) Chienes operation differs from Ogs
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