The operating room and the patient; a manual of pre- and post-operative treatment . physis, the restriction of OPERATIONS UPON SPECIAL TISSUES 337 growth is not very great. Unfortunately, however, the epiphy-seal line of the femur at least is almost always encroached on,owing to the extent of the disease. Eulenburg reported severalcases of paralysis due to angulation of the tibial nerve in thecoaptation of the sawed surfaces. Heinke demonstrated atautopsy in one case that the paralysis depended on the involve-ment of the nerve in the surrounding cicatricial tissue. was compelled to amp
The operating room and the patient; a manual of pre- and post-operative treatment . physis, the restriction of OPERATIONS UPON SPECIAL TISSUES 337 growth is not very great. Unfortunately, however, the epiphy-seal line of the femur at least is almost always encroached on,owing to the extent of the disease. Eulenburg reported severalcases of paralysis due to angulation of the tibial nerve in thecoaptation of the sawed surfaces. Heinke demonstrated atautopsy in one case that the paralysis depended on the involve-ment of the nerve in the surrounding cicatricial tissue. was compelled to amputate in a case in which the sawedsurface of the tibia projected backward and made pressure onthe popliteal nerve. In a second case in which the same dis-placement was present this did not occur; the displacementwas shown to exist by a subsequent amputation on account ofrecurrence of the tuberculous disease. After-treatment of Resection of the Ankle-joint.—Copiousdressings are applied, and the foot supported by a Volkmannsposterior splint with foot-piece, and two side Fig. 171.—Bracketed plaster-of-Paris splint for use after resection of theknee-joint. (Fowlers Surgery.) Constant care and watchfulness must be used in the after-treatment to maintain the foot at a right angle to preventabduction or adduction, and to preserve the foot in a positionmidway between pronation and supination. Partial resectiondoes not give such good final results as complete resection, andefficient drainage is not so easily secured. The Result of Resection of the Ankle-joint.—In the absenceof damage to the periosteum from suppuration, with the excep-tion of tuberculous cases, rapid repair and early usefulnessof the foot after subperiosteal resection of the ankle-joint isthe rule. The malleoli are reproduced, often at first exceeding in 22 338 OPERATING ROOM AXD THE PATIENT size the original. The shortening is slight in proportion to theamount of bone removed, an extra thickness of the s
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