. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. s, syphilis, tuber-culosis, may delay union of the fragments in a frac-ture-Extension treatment is the best to obtain rapid andsure union. Delayed union may be accelerated bypercussion of the fragments, injection of iodine andother preparations, or of blood, into the callus; bypassive hyperaemia, or by the administration ofphosphate of lime. Badly united fractures can be brought into betterposition by the osteoclast or by osteotomy. In the treatment of pseudarthrosis situated closeto
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. s, syphilis, tuber-culosis, may delay union of the fragments in a frac-ture-Extension treatment is the best to obtain rapid andsure union. Delayed union may be accelerated bypercussion of the fragments, injection of iodine andother preparations, or of blood, into the callus; bypassive hyperaemia, or by the administration ofphosphate of lime. Badly united fractures can be brought into betterposition by the osteoclast or by osteotomy. In the treatment of pseudarthrosis situated closeto a joint resection comes into question. Pseudar-throsis in the shaft can be repaired by bone the ends of the fragments are much atrophied(X-ray examination) they must be resected beforesuturing. The fragments may be resected so as tooverlap each other (dovetailed). The periosteummust always be spared as much as possible. Transplantation of bone has sometimes provedsuccessful. If no union occurs after these methods,apparatus must be worn, or amputation must beperformed. 132 Bockenheinier, Fig. 66. Luxatio cum liactura cruris — Pseudartlirosis. Rfbman Company, Ncw-Vork, In the treatment of fractures and dislocations,especially in fracture-dislocations, the X-rays areespecially useful in making an early diagnosis. Fig. 66 shows marked deformity of the lower partof the right leg as far as the ankle joint. On theouter side there is slight outwaid curvature of thefibula above the external malleolus. The peripheralend of the fibula is dislocated, so that the externalmalleolus projects and the skin bulges on the outerside of the ankle joint. There is an outward curva-ture of the right tibia above the inner malleolus. Thefoot is in the position of advanced flat-foot. The nature of the injury is an ununited supra-malleolar oblique fracture of the tibia. The distalpart of the tibia is freely movable, although the frac-ture is of two years standing. X-ray examinationsh
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