Excision of the knee joint : a description of a new apparatus for the after treatment ; with illustrative cases / by Patrick Heron Watson.

  • Watson, Patrick Heron, Sir, 1832-1907.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Excision of the knee joint : a description of a new apparatus for the after treatment ; with illustrative cases / by Patrick Heron Watson. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    18/88 (page 12)
    knee-joint was once excised in the Crimea, but the patient died: as was the case in the only instance where this operation is known to have heen performed for gunshot injury in the Schleswig- Holstein campaign.' The late Dr John Brown, in his Notes on the Surgery of the Indian Campaign of 1857-58, remarks: If there is a class of cases in military practice which demands that the knife should follow the wound, it is this class in which the knee-joint is injured by a musket ball. Occasional recoveries do not affect the question at all; for operative measures should always be had recourse to when there is ho chance of recovery without them; and that chance is too remote to be considered in comparison with the greater chance of a fatal result in this form of injury. The operation of resection of the joint, while still doubtful in most cases of disease, seems to me to be applicable to some of the cases of gunshot injury of the knee, provided there be little injury to the bones, and the camp be a standing one ; in marching armies the operation is decidedly inadmissible.* These extracts I have made in illustration of what I have already stated,—viz., that the great practical objection in connexion with the introduction of this operation consists not in the operative procedure itself or in the fatality as compared with amputation, but in the diffi- culties which have been found to attend on the after-treatment of the case. The operative procedure of itself is admittedly easy of per- formance, requiring no greater skill than an amputation, preferable surely to an amputation in the case of a wound of the knee-joint, when the injury inflicted on the articulation is confined to the epiphysis of either bone entering into the formation of the joint, because attended with less mutilation, and certainly entailing less life risk, requiring no gi'eat amount of skilled assistance, for no bloodvessel of importance is wounded; but rejected, as we have ' Holmes' System of Surgery, vol. ii. p. 84. * Notes on the Surgery of the Indian Campaign of 1857-58. By Jolin Bro-wn, M.D., Assistant-Surgeon Bengal Medical Service. Edinburgh Medical Journal, Sept. and Oct. 1860.