Symptomatology, diagnosis, and surgical treatment of cervical ribs / by W.W. Keen.

  • William Williams Keen
Date:
1907
Catalogue details

Licence: In copyright

Credit: Symptomatology, diagnosis, and surgical treatment of cervical ribs / by W.W. Keen. 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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    width of the vessel as it emerged from behind the scalenus anticus. Down to the point where it disappeared behind the clavicle it retained this enlarged diameter. Beyond that point it could not be followed. A small cigarette drain was placed in the wound, which, after douching with salt solution, was closed by ordinary sutures. The patient was placed in bed in admirable condition. In the afternoon of the operation her temperature rose to 100.6°. It was down to normal on the second day, and so continued until she went home. The cigarette drain was removed at the end of twenty-four hours, and the wound healed without note. I desired Left side Right side Fig. 5.—Keen’s case. Skiagraph showing the gap in the cervical rib left by the resection Opposite A and B are seen the stumps of the two ends. later to etherize her and break up the adhesions in the finger-joints so as to give her a more useful hand, but she was unwilling that this should be done. Immediately after the operation all pain disappeared from the left arm, and remained absent up to the time when she left the hos- pital, twelve days after operation. The bruit still persisted in the left subclavian, but there was no thrill. Pulsation was less evident than before the operation. The pulse did not return in any of the arteries below the subclavian. Within twenty-four hours after operation the left hand assumed a much better color, and in the course of two or three days its tern-
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