A system of surgery . pulous cleanli-ness is as essential in them as in the openplan. A. E. Barker passes a narrow scalpelinto the knee through the lig. patellae, andin withdrawing it cuts firmly on to the loweredge of the patella; a well-curved pedicleneedle is introduced and pushed through the quadriceps tendon as m„ 310j close to the patella as possible; the skinover its point is drawn up a bit, the point is cut upon anda knife passed intothe joint betweenthe needle and thebone, laying thebone bare as it iswithdrawn; theneedle is threadedwith wire or thestrongest sterilisedsilk (Fig. 311) a
A system of surgery . pulous cleanli-ness is as essential in them as in the openplan. A. E. Barker passes a narrow scalpelinto the knee through the lig. patellae, andin withdrawing it cuts firmly on to the loweredge of the patella; a well-curved pedicleneedle is introduced and pushed through the quadriceps tendon as m„ 310j close to the patella as possible; the skinover its point is drawn up a bit, the point is cut upon anda knife passed intothe joint betweenthe needle and thebone, laying thebone bare as it iswithdrawn; theneedle is threadedwith wire or thestrongest sterilisedsilk (Fig. 311) andwithdrawn; theneedle is now passedbetween the skinand patella frompuncture to punc-ture, the upper endof silk threaded(Fig. 312) and with-drawn ; the twofragments arerubbed together tillclot and soft tissues Fig. 311.—Barkers Method of suturing the Patella : the needle are removed, andpassed heneath the patella and threaded with silk (6, c). , •. , i i j? (A. e. Barker.) then the ends of 862 INJURIES OF Fig. 312.—Barkers Method of suturing the Patella : the needle(a) passed between the patella and the skin, and threadedwith the upper end of the silk (&, c), which lies behindthe patella. (A. B. Barker.) and another through the ligamentum patellae,each touching bone : the projecting ends arewired together (Fig. 313). Robson believesthat he gets bony union. In three cases Iobtained close fibrous union. Compound fractures should be treated bydisinfection and suture of some kind, unlessother bones are comminuted or soft partseriously injured, when excision or amputa-tion must be considered. Fractures of the leg bones, sepa-ration of the upper epiphysis of thetibia.—The upper epiphysis of the tibia isof large area, but not deep; it sends a tri-angular process downwards in front, whichends in the tubercle. Ossification beginsjust after birth as a rule, and ends at is much less frequently displaced than thelower epiphysis of the femur, owing to theattachment o
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Keywords: ., bookcentury1800, booksub, booksubjectsurgicalproceduresoperative
