I. The Mechanism of Dislocations and Fracture of the Hip: II. Litholapaxy, Or, Rapid Lithotrity with Evacuation

Little, Brown, 1894 - 356 páginas

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Página 159 - WYMAN has stated these general conclusions as to the arrangement of the cancelli in human bones. 1. The cancelli of such bones as assist in supporting the weight of the body, are arranged either in the direction of that weight, or in such a manner as to support and brace those cancelli which are in that direction. In a mechanical point of view, they may be regarded in nearly all these bones as a series of " studs" and
Página 121 - The next movement is a gentle rotation of the thigh outward, by inclining the foot toward the ground, and rotating the knee outward. Next, the thigh is to be slightly abducted by pressing the knee directly outward. Lastly, the surgeon freely flexes the thigh upon the pelvis by thrusting the knee upward toward the face of the patient, and at the same moment the abduction is to be increased.
Página 194 - ... the bladder. I believe that in any case which is as favorable to lithotrity as the average, in these days when stones are detected early, this can be effected ; and that if the bladder be completely emptied of detritus, we have as little to apprehend from the fatigue of the organ consequent upon such manipulation as from the alternative of residual fragments and further operations.
Página 213 - I like the blades of this instrument nearly as well as those of the fenestrated lithotrites by Weiss and Thompson already described . 'The blades of this lithotrite consist of a shoe, or female blade, the sides of which are so low that a fragment falls upon it ; while the male blade, or stamp, offers a series of alternate triangular notches, by whose inclined planes the detritus escapes laterally after being crushed against the floor and rim of the shoe. At the heel of the shoe, where most of the...
Página 123 - 2. Flex and lift while abducting. If this fails, it will be found that the rent in the capsule has been so enlarged that the first method may now prove successful." Bigelow adds to his first description three other methods of making the manipulation and applying the force, and, although the mechanism is the same in all, the multiplicity of the directions has been criticised...
Página 123 - ... found that abduction has carried the head of the bone from the dorsum nearly or quite to the thyroid foramen, and that the capsular rent has been so enlarged that the first method may now prove successful. Lifting the femur abducts it if it raises the pelvis on the lifted side. In thyroid dislocation...
Página 31 - He recommends, when the head is brought by abduction close to the lower edge of the acetabulum, that, by the rocking movement already described, it be caused to slip in. This is well, and will probably answer in many cases, but it failed us so completely from the first, that we were led to add the bringing down of the thigh to the straight position in a state of abduction, still keeping up the rocky motion, and it has been uniformly in the act of thus bringing down the limb, that the reduction has...
Página 31 - REID, MD, of Rochester, which have occurred in the New York Hospital during the past two years. By THOMAS M. MARKOE, MD, one of the Attending Surgeons.
Página 227 - The first part of this rule applies also to the introduction of a lithotrite, and even a curved catheter. A free injection of oil is important. 8. A small meatus should be enlarged, or a stricture divulsed, to allow the passage of a large tube. 9. If the bladder be not small, a large and powerful lithotrite is always better than a small one. 10. That this may have room for action, the escaping water should be replaced occasionally, through a tube inserted a few inches into the urethra by the side...
Página 119 - The best general rule for reducing a recent dislocation is to get the head of the femur directly below the socket by flexing the thigh at about a right angle, and then to lift or jerk it forcibly up into its place. This rule applies to all dislocations except the pubic, and even to that when secondary from below the socket ; the reduction by the lifting method is usually instantaneous, and flexion is the basis of its success.

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