Antiseptic surgery : its principles, practice, history and results / by W. Watson Cheyne.

  • Watson Cheyne
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Antiseptic surgery : its principles, practice, history and results / by W. Watson Cheyne. Source: Wellcome Collection.

    480/656 page 444
    Knee Wrist Elbow Foot Cases Deaths 15 8 5 0 0 0 0 No details of these cases are given, and we do not therefore know whether any further operative interference was necessary. In his paper on compound fractures,' Volkmann adds the fact that 21 compound fractures passing into joints were treated without a death. With regard to these last 21 cases, we have some further particulars. In 2 instances resection was at once performed ; in 5 resection was performed secondarily; in 3 amputation was performed secondarily; in 10 there was perfect recovery with freely movable joints ; and in 1 case there was recovery with anchylosis, but the treatment was not commenced in this instance till thirteen days after the injury, and the joint was then already suppurating. In all these cases there was extensive injury of the bones as well as wound of the joint. In 3 cases the secondary operation was performed because the patient was not admitted for some time after the injury, and the joints were already suppm-ating; in one case the supervention of gangrene rendered it necessary, and in the other cases the nature of the wound, mal]3osition of the fragments or suppuration of the joint, required it. Of course in considering cases of ivounds of joints it must always be remembered, that one can never be certain that all the causes of putrefaction already present have been destroyed, and therefore, the probable result is very diiferent from, i.e. much more uncertain than, that where the surgeon makes the wounds himself, and where, therefore, he has merely to exclude these causes. This is well illustrated in the case of compound fractures. Max Schede, in his work on amputations, states that he has treated 15 cases of compound fracture in which joints were opened. Of these 10 were treated conservatively and healed, in 9 instances (5 of elbow, 2 of hand, and 2 of foot) with movable joints, in 1 with anchylosis, where the case was not admitted for some time, and where there was extensive com- ' 'Die Behandlung der complicirten Fracturen,' Volkmaims Sammlung, Nos. 117-118.
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