The morning call., 1891-01-11
THE SURGEONS KNIFE.
A Remarkable Case Successfully
Treated at New York.

One of the most remarkable operations in
osteotomy ever performed in which the
value OF the skill of the surgeon is shown is
that of the case of Lillian Schick, patient
at st. Elizabeth Hospital says New York
correspondent of the Cincinnati Enquirer.
The patient Is young girl. While she
was baby she was left in charge of an
elder sister, and through her carelessness
the child fell from third-story window to
the yard. 1t was one of those miraculous
escapes from instantaneous death that some
times happen, and all the apparent injuries
were few bruises on the body and head.
AS the child developed a peculiar and I'M
usual defOrmity was noticed The thigh
bone of the right leg curved outward and
the same bone in the left leg curved inward.
There was similar defOrmity. only more
marked. in the bones in the leg below the
knee. The development of these was grad
ual, as was also horrible maliormatiou of
both feet. The feet were drawn backward
so that their bottom was ut right angles
with the calf, and the toes were fattened
against the sole. The child actually stood
on its ankles. This was not all of the de-
formity, for anchyl0sls had occurred at the
hip, and both joints were as stiff as bar of
iron.
This was the condition of the girl when
she was admitted to the hospital, and ordi-
narily she would have been thrown into the
cave of the incurables But there were
money and influence at the girls back, and
this IS a potent factor in medicine as we'll as
elsewhere.
Professor Parks. the expert lecturer on
osteologv, did not relish the outlook, but he
pulled all his knowledge and experience to-
getIer and went to work on the girl. The
hrst point OF attack was the thigh bones.
The patient was given chl0rOfOrm instead
oil ether. and on account OF a functional de-
iect In the heart, barely enough was given
to deadeh the pain, so that she suffered
more or less during the operation. The
mesh was cut into on the outside of one
thigh and inside of the other, and the bone
exposed. Retractors were used to pull the
flesh apart Then the bone was cut about
two-thirdS through with chsel and
hammer The chsel slipped twice. but,
fortunately, did not injure any Of
the large blOod-vessels. BY using the
leg as lever, the bones were
broken where they had been weak ened.
Attention was then given to the bones be-
low the knee, which were broken after be-
ing partially divided with the chisel. The
hemoTrhage was controlled by SpGnSeS and
pressure. The broken bones were put in
position of Overcorrection and roller ban
dages were applied. The entire leg was en-
Veloped In plaster OF paris, with small open
lngs over the wounds left for dressing aud
drainage. The bones united in four weeks,
and the plaster bandage was removed. The
surgeon then operated on the hip Joint, and
removed such parts of the socket as inter-
fered with the rotary motion. This was a
dangerous, as well as delicate task. and the
surgeon repaired the joints in both legs
without accident. These wounds healed
raridly, and when the patient had fully re-
covered her strength the surgeon tackled
the tallpes equine-varus in the feet. The
operation was one of the grandest ever
undertaken IN surgery. The tendon
Achilles, tiblals anticus and ti5ialis post
Gus were first divided by open section.
All the little tendoDs, muscles and bones
which interlered with the feet being re-
stored to their natural position were cut
shortened or removed in part, as the ext
gency demanded. When this had been done
the feet were forcibly brought 10 the nor
NAL position and held there with plaster of
paris Splints. On account Of the extensive
destruction of tissue and tend0ns and the
difficulty in removing all the small splinters
OF bone the wounds became infected and
healed very slowly. The general condition
of the patient remained good throughout
and she Is now in fine shane. The success
IN removing the mechanical Instructions to
free motions in the legs is wonderful. The
patient, though weak, has the free use of
ner legs in walking, and the only drawback
Is slight limp, which, 1t Is believed, viii
wear away.