Antiseptic excision of the knee-joint / by Charles Coppinger.

  • Coppinger, Charles.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Antiseptic excision of the knee-joint / by Charles Coppinger. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    These tubes are constructed of the best description of rubber, as recommended by Mr. Lister, and they are quite reliable in this respect, for the very good reason that they cannot be constructed of the impure or vulcanised material. They can be cut to any length, and can be easily inserted by means of a probe notched at the end, as shown in the woodcut. By the use of these drains, which I devised some years ago, and of which I have had a large quantity constructed,8, the annoyance, caused by the slipping of the ordinary drainage tube altogether into an abscess or wound, is avoided. This is, of course, but a small evil when it occurs with the Neuber drainage-tube of decalcified bone, as indeed it is very liable to do, but the matter becomes rather serious when a rubber tube meets a similar fate, and is perhaps destined to remain (as in a case which I lately heard of) in the patient’s pleural cavity as a permanent relic of a former operation. The following are brief notes of the cases in which I have, up to the present, made use of this splint:— Case I.—J. M‘C., a delicate-looking girl, aged twenty-four, was admitted to the Mater Misericordiae Hospital in June, 1879, suffering apparently from articular osteitis, with degeneration of the left knee- joint, the disease being of five years’ duration. There was no history of injury to the joint, and there was not at any time much pain or swelling in connexion with the disease. The operation, which was performed antiseptically July 9, 1879, revealed, however, the presence of an abscess about the size of a walnut in the head of the tibia, adjoining the left semilunar cartilage, which had been perforated by the opening of its cavity into the joint. In this case not more than the usual amount of bone was removed, but an aperture was drilled through the tibia from the side, so that a short drainage-tube could be passed into the abscess in the head of the bone, its other end protruding through the angle of the incision in the soft structures. Very slight constitutional disturbance followed the operation, the temperature never rising above 100°, and little or no pain was complained of. After eight weeks the thumb-screw, by which the leg and thigh portions oi the splint were bound together, was loosened temporarily, and bony union ascertained to be quite firm. As, however, the external wound had not closed, it was then thought better, mindful of the cavity which had existed in the tibia, to defer the removal of the apparatus; but, a month later—that is, twelve weeks after the operation—the splint 11 These drainage tubes are now to be had of all sizes from Messrs. Fannin & Co., of Grafton-street, and from Mr. Whyte, of Sackville-street, Dublin.