American practice of surgery : a complete system of the science and art of surgery . nt fractures of theradius seen by Hamilton occurred in this portion: and in the lower third, wherethe great majority of the fractures of this bone occur, he had never seen anexample of non-union. In approaching the shaft of either the radius or the ulna for operation onan ununited fracture, the incision should be made from the correspondingside of the forearm, and on both sides if both bones are involved (see Fig. 124).The same care should be observed to preserve unlimited the interosseous space 244 AMERICAN P
American practice of surgery : a complete system of the science and art of surgery . nt fractures of theradius seen by Hamilton occurred in this portion: and in the lower third, wherethe great majority of the fractures of this bone occur, he had never seen anexample of non-union. In approaching the shaft of either the radius or the ulna for operation onan ununited fracture, the incision should be made from the correspondingside of the forearm, and on both sides if both bones are involved (see Fig. 124).The same care should be observed to preserve unlimited the interosseous space 244 AMERICAN PRACTICE OF SURGERY. as in a recent fracture, to prevent the possibility of binding of the two bonestogether by callus. Because of the small size of the bones, light fixationdevices arc to be employed. Most surgeons prefer the wire suture, but in thewriters opinion light plates and screws are better, because they provide betterfixation, require less disturbance of the fragments, and leave no foreign bodypermanently in the tissues. In some cases if one bone only is ununited and the. Fig. 125.—Ununited Fracture of Both Rones of the Forearm. Parkhills plates and screws inthe radius. (Skiagraphed by Dr. 11. K. P an coast. 1 other united, it will be necessary that a corresponding portion of both shouldbe removed and both treated in the same way. It will sometimes be foundthat mechanical fixation of one bone will provide sufficient immobilizationof the other (see Fig. 125). Femur.—Of 100 cases of pseudarthrosis of the femur in Agnews tables,8 were in the neck. 16 in the upper third, 04 in the middle third including itsjunction with the upper and lower third, and 12 in the lower third. PSEUDARTHROSIS. 245 Until recent years little or nothing had been done to obtain union by opera-tion in ununited fracture of the neck of the femur, which is very suffering from this condition generally remain cripples for life. Gil-lette and Boeckmann* in 1898 reported three successfu
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