Osteotomy and osteoclasis for deformities of the lower extremities / By Charles T. Poore.

  • Poore, Charles T.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Osteotomy and osteoclasis for deformities of the lower extremities / By Charles T. Poore. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    cision should be so planned as to avoid any artery or vein. The length of the wound should be only sufficient to easily admit the osteotome. This in- strument is then passed down upon the knife as a guide, and, when the former is well down upon the bone, the latter is withdrawn, and the osteotome is rotated so as to be at right angles with the long axis of the bone, and then driven in with pretty firm blows with the mallet. After each blow the in- strument is moved in a direction at right angles to the long axis of the bone—that is, in the line of the axis of the instrument—in order to keep it from be- coming wedged and to change the direction of the cut in the bone. It is also well, in bones of any width, to first divide the bone throughout its superficial surface, and then gradually to work from without inward through its width. Under no circumstance should the osteotome be used as a lever, as it will result in breaking the instrument. In some cases the bone may be divided in a fan-shaped manner by working in different directions from the point of first entrance. Divisions should be commenced with the largest osteotome, if the bone is of any size, as the femur or tibia, because after a time the instru- ment becomes wedged and is difficult to work. It can then be withdrawn and replaced by the next smaller, this to be again replaced by the third if necessary. Another reason is, that, by using the lar- gest first, the cut is made more V-shaped. When the osteotome has penetrated the hard, compact, bony tissue in the external portion, it will be felt to work more rapidly. When the external portion on the opposite side of the bone is reached, it will