A manual of operative surgery / By Lewis A. Stimson ... and John Rogers.

  • Lewis Atterbury Stimson
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A manual of operative surgery / By Lewis A. Stimson ... and John Rogers. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    muscles inserted upon the greater tuberosity, is carefully detached with the elevator and kniib. while an assistant rotates the arm inward to increase the extent of and facil- itate the dissection. The tendon of the biceps is then raised from its groove and hold out oT the way, the arm rotated outward, and the periosteum, capsule, and tendon of the subscapulars dis- sected off in the same way on the inner side. The head of the humerus is then dislocated forward, the posterior attachments of the capsule separated with the elevator or knife, the periosteum peeled off the posterior face of the neck and shaft of the humerus, and the bone sawn through transversely. If the articular surface of the glenoid cavity is affected, it must be scraped ; if the bone itself is diseased, it should be gouged out until healthy bleeding bone is reached, or the neck may be cut through with strong cutting-pliers after removal of its periosteum. Von Lanoexbeck's Method differs slightly from the above. He begins his ippisinn «t, thp nfltprjnr border pf the acromion just outside of the a^aamjc^ajdcjilax junc- tion, and carries it directly downward, the arm being so held as to bring the outer condyle of the humerus in front. This sacrifices the inner fibers of the deltoid by severing their nerves. He carries the incision through the muscle down to the capsule and bone, then raises with toothed forceps the sheath of the tcmlun of thftJ>i<ms which presents in theTine of the incision, and opens it carefully from without inward. As soon as the shining tendon ifi Been he slits the sheath throughout the entire length of the incision, opening the capsule quite up to the acromion, and exposing the articular end of the humerus with the tendon lying upon if. He then raises the periosteum on the inner side, until the hsser tuberosity is reached, lays aside the elevator, and peels oh the tendon of the Bubscapukris with l^rjjjc and toothed force]is, taTmg~TlTTrgreatest pains to maintain its relation- with the capsule and periosteum. After this dis- Bection has been carried as far as possible on the inner