Atlas and epitome of traumatic fractures and dislocations . £)iia)ndz/lus mediaUs Ertunenfia, intercondyLoideaConxiylus medlaUs femoris CondyLus medwlLs tibiae—* - / Maryo Cnfraylenoidcdis Ulna. Fig. 138. sagittal direction (vertical) and draw the fragments to-gether in the form of a buried suture (Barker). Theligature is introduced by means of a long, appropriatelycurved needle, through two small incisions, one above, andone below, the patella. The old method by means of Mal-gaignes hooks has now fallen into disuse. On the otherhand,primary suture of the fragments, after exposing the seatof f
Atlas and epitome of traumatic fractures and dislocations . £)iia)ndz/lus mediaUs Ertunenfia, intercondyLoideaConxiylus medlaUs femoris CondyLus medwlLs tibiae—* - / Maryo Cnfraylenoidcdis Ulna. Fig. 138. sagittal direction (vertical) and draw the fragments to-gether in the form of a buried suture (Barker). Theligature is introduced by means of a long, appropriatelycurved needle, through two small incisions, one above, andone below, the patella. The old method by means of Mal-gaignes hooks has now fallen into disuse. On the otherhand,primary suture of the fragments, after exposing the seatof fracture and opening the joint, is constantly gaining ad-herents. It can, of course, only be intrusted to a practisedsurgeon, but has the distinct advantage of removing all thedisturbing factors that interfere with complete union, andsecuring the nicest adaptation and fixation of the fractured Tab. 62 FRACTURES OF THE LOWER EXTREMITY. 299 surfaces. The extravasation of blood is removed, the tagsof fascia adhering to the fracture surfaces snipped away,holes are bored with as little damage as possible to thecartilaginous surface, and the wire sutures drawn throughand twisted. Every step in the operation should be per-formed with carefully sterilized instruments, withouttouching the parts with the hand, which is so difficult todisinfect (Konig). Some surgeons confine their efforts torepairing the tear in the aponeurosis on each side of theknee-cap; but an additional suture through the bone un-doubtedly secures a better result. Instead of insertingsutures through holes previously drilled in the fragments,a single vertical loop of strong silver wire may be passedaround the patella, after the manner of Barker, after theseat of fracture and the joint have been laid wide open by acurved incision running transversely over the entire wire is removed at some later time. I have fre-q
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfractur, bookyear1902
