Modern Operative Bone Surgery; With Special Reference to the Treatment of Fractures

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1918 edition. Excerpt: ...after which time good results can be obtained, if the open method is used. For clinical purposes, simple fractures may be divided into three groups: --Group i. Fractures that can be reduced by manipulation, and held in perfect position by external fixation; in such cases the open method is counterindicated. In this very large group of fractures good functional and anatomical results may be, and are, obtained by the external method. Group 2. Fractures where the fragments cannot be reduced by external manipulation to perfeet anatomical relations. The fractured ends should be exposed by an incision, and the broken ends of the bone placed in proper position. After reduction has been perfected, if the fractured ends can safely and securely be immobilized by external fixation, internal fixation is not required. Group 3. Fractures where it is necessary to expose the fractured ends by an incision to bring about a proper reduction, and where it requires internal alignment and both internal and external fixation or immobilization to secure the desired results. The execution of the technic involved in the application of the bone-graft necessary to assure success, and many of the conditions that I have enumerated, would be difficult, slow, and inaccurate, except for the application of the electric motor and attachments, such as twin saws, drills, burrs, and doweling instruments. These save time, avoid trauma, both to the bone and soft parts, favor precision in modeling the graft and preparing its bed, and simplify and make easy the technic in deep wounds and regions difficult to get at with hand instruments. Crile says that the motor instruments diminish shock, on account of the lessened excitation of the efferent nerves by the rapid movement, and..