Weekly Trinity journal., 1861-02-23

SURGICAL OPERATIoN.-We were present at the
county Hospital, on Wednesday, to witness the
operation of excsion of the knee joint perform
ed by Dr. Hoffman,, Hospital Physician, DR.. r.
A. Thomas and DR.. Edward Trask.
If we are rightly informed, the operation is one
comparatively new in the history of surgery.
Although occasionally undertaken, rather as an
experiment, by eminent surgeons during the last
half century, it is only within the last few years
that it's importance has been recognized by the
profession valuable substitute for amputa.
tion in cases to which it was applicable. 1t con-
sists in removing the joint, and creating a union
be tween the bones from which it has been sever
ed, leaving the person with useful, although
shortened limb The skill with which the opera
tion was done reflects credit on the surgeons who
are mentioned above, and especially DR.. Thomas.
We are pleased to hear the operation is likely to
prove entirely successful Only twenty minutes
was occupied in performing the operation, the
subject being under the influence of chloroform
The following description of the case has been
kindly furnished us by DR.. Thomas:
Chas ID. Degere, aged AZ years. a native of
DanZig, Prussia, was admitted to the Hospital,
under care of DR.. Harris, in July last, with an
axe wound in the left knee. In November Dr.
Hoffman took charge of the Hospital, and found
him very low and much emaciated, with the leg
fexed at right angles, and fixed by ancby loss.-
A large quantity of unhealthy puss discharged
from several openings in the knee probe intro
duced, came in contact with dead bone i'm every
direction I; the knee cap felt to be separated
in several places by liberation. DR.. Hoffman,
put him under tonic course of treatment, with
nutritious diet, under which he improved, the dis
charge being of a more healthy character. 1t
was determined in consultation to perform excis-
ion of the knee joint instead of amputation-
The patient had also large double hydrocele,
which was opened on both sides with trocar,
and about forty ounces of water evacuated.
! The operation of excision was performed by
making semi lunar ncison from the internal to
external condyle of the thigh bone beneath the
patella, or knee cap. The flap was dissected
back, Gncluding the patella, the fragments of
which adhered firmly to the capsule and integu-
ments) followed by the escape of puss The car
tilage of the femur was entirely DESTROYED. and
the bone carious About Il inches of this bone
was sawed oil, and as the abcess was found to ex-
tend up the spongy portion of the bone, another
slice was removed, and the remainder of the ca
rious portion taken away with gouge. The
cartileges of the tba were not affected. The
bone taken from the femur was detached from its
adhesions, the sharp external edge of the con.
dyle taken of, and the ends of the bone adjusted.
About two inches of the flap was trimmed off,
and the flesh above and below brought together
by stitching and adhesive plaster. The limb was
placed on carved splint, with the knee slightly
raised, and fastened by straps to foot board,
with band above and below the knee.
But small quantity of blood was lost during
the operation, no vessels requiring to be tied.
The patient complained of some pain about
the heel in the evening" and was sick at the stom-
ach from the effects of choroform, but after TAX
ing some wine with solution of morphia, passed
comfortable night.