Caries of elbow joint : operation of excision, with recovery of useful arm : presented to Medical Society of the State of New York at its annual meeting 1862 / by N. C. Husted.

  • Husted, N. C. (Nathaniel C.), 1825-1891.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Caries of elbow joint : operation of excision, with recovery of useful arm : presented to Medical Society of the State of New York at its annual meeting 1862 / by N. C. Husted. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    as much as possible the attachments of the biceps and brachialis anticus. It was now found that the disease embraced the arti- cular surfaces of the humerus and the structures of the condyles nearly as far as the shaft of the bone. The articular surface of the ulna, together with the structures of the olecranon and coranoid processes, were involved also in the disease, but the head of the radius was healthy. The protruding end of the humerus was firmly held by one of the assistants, and the inte- gument being retracted and protected by a napkin, I excised the diseased portion just above the olecranon fossa with a small am- putating saw. The excised portion measured about 1^- inches. The entire ulna was then excised, at a point immediately below the base of the coranoid process. A thin lamina of the articu- lar surface of the radius was next sawn off with a Hay's saw; and, finally, the sharp edges of the excised ends of the bones were very carefully rounded with the gnawing bone forceps. The ulnar nerve was preserved intact. The amount of the hemorrhage during the operation was very trifling. Only two ligatures were used. There was some general oozing of blood, which was arrested by the application of the liq. ferri perchlo- ride (Dr. Squibb's) and ice. After keeping the wound open for five hours, Dr. Merritt and myself then dressed the wound, by introducing three silver wire sutures, with several silk ones intervening, and applying straps of adhesive plaster, which accurately apposed the edges of the wound, excepting the lower corner of it, this being left open to allow the exit of the subse- quent discharge. The forearm was then flexed on the arm to a right angle, and both were carefully supported by pillows. Iced water dressings were applied, and an anodyne ordered if neces- sary. The patient had rapidly rallied from the effects of the anasthesia and operation, and after the dressing was in a very comfortable condition. The operation occupied about thirty minutes. Sept. 29th. The patient had passed a very comfortable night; no anodyne given; moderate reaction had occurred, and the wound was in a very favorable state, the edges being well agglu- tinated together, the surface surrounding cool and only slightly swollen. There had been some oozing of blood from the wound during the night. The adhesive straps were divided to relieve the slight tension of the parts, and water dressings continued ; low diet and sig. ammonia acetatis ordered.