The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . or dislocations may also prove an indication for the operation, if thedisplaced bone cannot be replaced, and if it threaten to produce sloughingby pressure upon the integument. Excision of the astragalus may be conveniently effected by making a semi-lunar incision on the anterior and external aspect of the joint (Fig. 749).The removal of the bone may be rendered easier by first cutting across itsneck with stronij pliers, and then dislodging each fragment in successionwit
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . or dislocations may also prove an indication for the operation, if thedisplaced bone cannot be replaced, and if it threaten to produce sloughingby pressure upon the integument. Excision of the astragalus may be conveniently effected by making a semi-lunar incision on the anterior and external aspect of the joint (Fig. 749).The removal of the bone may be rendered easier by first cutting across itsneck with stronij pliers, and then dislodging each fragment in successionwith elevator and forceps, using the probe-pointed knife in the deep parts ofthe wound. In some cases, however, the bone has to be removed piece-mealby means of the gouge. My personal experience in excision of the astragalus is limited to two See also tables on pages 444 atul 445.« Ibid., page 302. » See page 470. EXCISION OF THE CALCANEUM. 529 cases—one in which I successfully removed the bone, in a state of necrosis,following injury, in a man aged 4U ; and another in which I removed both Fig. k ^ Excision of the astragalus. astragalus and calcaneum, in an old man, for caries, the patient doing wellfor several months as regarded his local condition, but ultimately dying frompulmonary phthisis. The statistics of excision of the astragalus have been particularly investi-gated by Hancock and b}^ Poinsot.^ The former author has collected 112cases of total, and 28 of partial excision. Of the complete operations, 79gave the patients useful limbs, 2 were followed by amputation, and 19 bydeath, the result in 12 cases not having been ascertained; the mortalitvof terminated cases was, therefore, 19 per cent. The partial operationsgave 18 satisfactory recoveries, 8 less satisfactory or unknown results, and 2amputations, of which 1 was followed by death. Poinsots table embraces144 cases, of which 26, or 18 per cent., terminated fixtally. The joint between the astragalus and the cal
Size: 1667px × 1498px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1880, bookpublishernewyo, bookyear1881
