The sun. [volume] (New York [N.Y.]) 1833-1916, 1914-01-04

,,r If asepsis-absolutc surgical clean |
Illness the modern operator stretches
trtl skilled courageous hands. lifts
r, hopeless cripple" from his bed and
s,.,s him up again Il sound and useful
r,,,,n,r " society.
PHYSICIANS for generations have OBJ
sorycd that when muscle ar other soft
,issu, becomes interposcd between the
,,d. If broken bones false Joint re-
s,l,. That is instead NJ the frag-
mcrt- knitting as they should. n NOV
nil, i,nt develops. with the forma-
,,ou II cartilage, membranes and lubri-
eating fluid exactly like Il normal Joint.
I, has been a common observation also
,ho, serious injury. inflammation or
,,,,,,ir.. If a Joint Is very likely to leave
m, ioint partially or wholly useless
immoyable or ankyloscd. as "A doctor
would say.
H. order ,u remedy the former con-
ari,r uon-union or false Joint at the
sea, Of fracture it Is customary for
,ba surgeon IN cut down on the frac-
t1r, clear the interposcd soft tissues
ovt,. frcshcn the fractured ends and
wire. nail ur otherwise hold them in
contact until bony union can take place.
The majority Of these operations. even
under discuuraa,ne conditions. prove
remarkably successful.
For the stiffened or ankylosed joint.
~, la
cure II efforts at passive motion
failed to give benefit the alternative
has been to place the patient under
ether furcibly break up the fhrous or
body adhesions binding the joint, and
then trust Ia good fortune that some
notion may remain when the reaction
from this rough handling subsidies. This
measure has unfortunately. failed in
many instances; and. for old chronic
cases ri absolutely rigid joint Of years
standing i scarcely applicable AT all
About 1900 Or. John Il Murphy. the
Chicago surgeon, undertook "a series Of
experiments ON animals. looking toward
n, formation ot new joints. and In
1907 he performed the original opera
ton upon human being. Curiously
enough. Or. Murphys procedure is an
excellent imitation Of the work Of that
tJng.n- old surgeon who has been
making new joints in the wrong place
these many centuries Mature. That
is 10 say. Or. Murphy simply inter-
posts certain soft tissues between the
bones where the movable joint is re-
CURED nails the necessary extra por-
tons Of bone in place with plain wire
nails. and sews up the job with con-
fidence in his own asepsis and ma
lures kindly aid
In joint surgery as nowhere else rigid
aseptic technic is imperative. The slight
est shortcom.ng in this essential spells
failure If not worse disaster. That Is
why so few surgeons of even recognized
ability as vet dare attempt the opera
l.pn Dr. Murphy performs SO success
fully. they haven't sufficient confidence
in their own ability.
Not even gloved hand must be
sponge or instrument" writes DR.. Muir
ply. describing his technic in the An
mails Of surgery. The nutrition OF the
tissues is such that they cannot with
stand infection az well as normal tissue
does. and therefore We are exceedingly
careful in practising all the principles
Of aseps!s."
Obviously this work is not for the
all round specialist who operates as a
Sideline. IF our aseptic precautions
are effective" reiterates the distin-
gu.shed author, half the battle is won"
on the other hand, If any break oc-
well for instance: \ morphine hab!tus
had both hip joints operated on. The
operation on the first oac gave good
movable Joint. But twelve days after
the patient tore off the bandages in "A
f. II anger because the nurse would
not give him morphine; he developed
wound Infection which in spite OF every
F''Nl'lf tlIbIt W tIt WNH' VIZ
to a fatal terminate three weeks later.
In operating on ankylosed or useless
FONTS the steps are clearly prescribed
'y Dr. Murphy. II it is. say, hip
loin' to be restored, the first thing
necessary is TO saw of the bony prom
!nrn." called the trochanter, or COM
mInA the prominence of the hip. This
gives access TO the underlying hip joint
The head Of the thigh bone is now
tt.-c!icd out Of its bed in the socket Of
'A' hip, an ordinary carpenters chiscl
an mallet being employed for this
work The socket is then ground
'mo'.h with a reamer and the rough
bah II the thigh bone milled with a
cap shaped end mill to fl perfectly the
newly ground socket. the Instruments
being fashioned very accurately for this
purpose
"'Nt a flap OF fascia and fat from
just hcneath the skin OF the thigh Is
'.'- 'ctcd free at one end. drawn into
a. Joint and stitched in place with n