A manual of the operations of surgery : for the use of senior students, house surgeons, and junior practitioners / by Joseph Bell.

Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the operations of surgery : for the use of senior students, house surgeons, and junior practitioners / by Joseph Bell. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    ion, as there is less thickening of the skin and subjacent 'xtures, and in consequence more risk of deficiency and ven sloughing of the flaps made by the H-shaped inci- on, a single straight incision will serve the purpose Imirably. Partial excisions of the elbow-joint are invariably less uccessful and more dangerous to life than complete ones, >en in gun-shot wounds, where the bones were previously lealthy, and where uninjured portions might have been J ft with some hopes of success, this is the case. The mortality from this operation is considerably less han that from amputation of the arm. Thus out of 82 cases where the joint was excised for njury in the Schleswig-Holstein and Crimean campaigns, )uly 16 died; and out of 115 cases in which the joint vas excised for disease, only 15 died. The period after the injury at which the excision is per- ' irmed seems to be important: Deaths. Thus of 11 cases within first twenty-four hours, 1 =1-11 20 ,, between second and fourth days, 4=1-5 9 ,, eighth and thirty-seventh, 1=1-9 40 6 Excision of the Wrist.—Very various methods have leen proposed and executed for the purpose of excising this ooint. These vary much in difficulty and complexity, in (Droportion to the endeavours made to save the tendons from Hieing cut. The principles which must guide all attempts at opera- iive interference with this joint are :— 1. To remove all the diseased bone, including the carti- eige-covered portions of the radius, ulna, and of the meta- tarpal bones, as little of these bones being removed as loossible, beyond the cartilage-covered portions. 2. To disturb the tendons as little as possible, especially CO avoid isolating them from the cellular sheath.