The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . formed for malignant disease, the whole scapulashould be excised (Fig. CtdG), but, under other circumstances, it may be betterto substitute partial excision ; and there is certainly an advantage in retain-ing the neck of the bone and the glenoid cavity (not opening the joint), withthe acromion and coracoid processes, when nothing can be gained by theirremoval. Under these circumstances, the bone is to be divided at the properpoints with the saw or cutting forceps, and even in complete exci
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . formed for malignant disease, the whole scapulashould be excised (Fig. CtdG), but, under other circumstances, it may be betterto substitute partial excision ; and there is certainly an advantage in retain-ing the neck of the bone and the glenoid cavity (not opening the joint), withthe acromion and coracoid processes, when nothing can be gained by theirremoval. Under these circumstances, the bone is to be divided at the properpoints with the saw or cutting forceps, and even in complete excision, it willcommonly be found more expeditious to use the saw at the acromio-clavicularjunction than to attempt disarticulation. The coracoid process also may besawn through at any convenient point, and its tip afteiwards dissected outwhen the removal of the tumor has been completed. In order to free the See Vol. I. p. 647. 4G8 EXCISIONS AND RESECTIONS. glenoid cavity, the joint should be opened, and the capsular ligament thencarefully divided with the probe-pojntod knife or with scissors. Fig. ^^^^9*5?^ Excision of the scapula. The mass having been removed, all bleeding vessels are to be secured,drainage tubes introduced, and the wound then closed with stitches. Thearm may be placed upon a Stromeyers cushion,^ until the flaps have fairlyunited, and the arm afterwards simply supported in a sling. It may sometimes be necessary to remove, with the scapula, a portion ofthe clavicle, the head and neck of the humerus, or both. These additions tothe operation of course greatly increase its gravity, and the parts in questionshould not be interfered with, if such a course can possibly be avoided. The acromion j^rocess or the spine of the scapula may readily be removedthrough a single transverse incision. The history and statistics of excision of the scapula were made the subjectof special investigation by the late Dr. Stephen Rogers, of New York.^ andhave been more recently stud
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