International Medical Annual and Practitioner's Index Volume 10

International Medical Annual and Practitioner's Index Volume 10

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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1892 edition. Excerpt: ...removal of large portions of bone, but would leave most of the synovial membrane intact. The method advocated by Bruns is a modification of Ko'nig's operation for resection of the ankle, which is performed by two long anterior incisions. This operation, it is stated, exposes the anterior synovial sac, and permits of removal of this membrane and of the diseased portions of tibia and astragalus, but the back of the ankle remains inaccessible, and the posterior synovial membrane cannot be removed unless the whole of the astragalus has been resected. To the two anterior incisions made in K6nig's operation, Bruns adds two posterior incisions, carrying one along the inner, the other along the outer, edge of the tendo Achillis. The following are the steps of the operation as performed by Bruns: Two vertical incisions are made in front of the ankle, each commencing about four centimetres above the line of the joint, and carried downwards in front of the corresponding malleolus as far as the medio-tarsal joint. The intervening portion of soft structures having been separated from the bones, the anterior synovial sac is dissected away. The interior of the joint is now exposed, and the ends of the bones may be dealt with according to the extent of the disease. If there be merely a tuberculous deposit in the lower end of the tibia or in the head of the astragalus, this may now be completely removed. If, however, as is usually the case, the whole of the joint be diseased, the articular extremities of the tibia and astragalus and both malleoli must be removed, and one or two posterior vertical incisions be made so as to expose and allow removal of the rest of the synovial sac. Removal of the whole or a greater part of the astragalus, if...
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Product details

  • Paperback | 258 pages
  • 189 x 246 x 14mm | 467g
  • United States
  • English
  • black & white illustrations
  • 123696148X
  • 9781236961488