The question of operative interference in recent, simple fractures of the patella / by Charles A. Powers.
- Powers, Charles A.
- Date:
- 1898
Licence: Public Domain Mark
Credit: The question of operative interference in recent, simple fractures of the patella / by Charles A. Powers. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![] placed the table marked “ Satisfactory” at the head of the list rather than one marked “ Perfect,” for the number which could be accurately grouped under the latter caption would be misleading. So far as immediate results go I question whether operation offers much of a gain over the Dutch sage method. By either form of treatment the patients re- sume daily life much earlier than when treated by the older methods. In the personally communicated opinions set forth in the foregoing pages it will readily be seen that the con- sensus of opinion goes to show that operation saves a goodly amount of time to the patient when compared with confine- ment measures. But in the ultimate history'of the limb the condition of the callus plays a most important part. A fibrous callus tends to stretch and ultimately to break, and while I have thought it best to discard the term bony union, the history of these cases goes to show that if the union be so complete as to ren- der independent mobility of the fragments impossible, it is improbable that it will become incomplete or such as to allow of their mobility. That osseous suture gives by far the greatest percentage of complete union is evident, and, further, I am convinced that it gives the smallest percentage of refractures, a matter of no small importance. This matter of refracture has been carefully studied by Begouin and Auderodias {Gazette Medi- cate de Paris, 1897, p. 505), who cite thirty cases from Ham (“ En nadeclen van de Behand,” etc., Amsterdam, 1893) and add five personal cases, each of the thirty-five treated by mas- sage and followed for a sufficient length of time. In 8 or 22 per cent, there was subsequent rupture of the callus. In a complete search of literature these authors find but seven iterative fractures after operation. (Reported by Peyrot, Lucas-Championniere, Mounod, Mayo-Robson, Stimson, and themselves.) While this number of cases is far too small to permit of conclusions, it is a fact that the closer the union the less is the danger of refracture, and it must be seen that](https://iiif.wellcomecollection.org/image/b22451808_0045.jp2/full/800%2C/0/default.jpg)
