0
Journal Contents   |    
THE MANAGEMENT OF PENETRATING WOUNDS AND SUPPURATIVE ARTHRITIS OF THE KNEE JOINT IN THE MEDITERRANEAN THEATER OF OPERATIONS
OSCAR P. HAMPTONJR.
View Disclosures and Other Information
Medical Corps, Army of the United States
1946 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1946; 28:659-680 
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case
text A A A

Abstract

1. At the time of the initial surgical treatment, the preferred plan of management for penetrating wounds of the knee joint—regardless of the time interval between receiving the wound and operation—should include arthrotomy; excision of the devitalized tissue, including areas of destroyed articular cartilage; cleansing of the blood clot and debris from the joint; suture of the synovial membrane or capsule; and immobilization of the limb in a hip spica or a Tobruk splint.

2. At the time of reparative surgery, preferably from five to ten days after the intra-articular surgery, the skin should be sutured.

3. Immobilization should be discontinued as soon as the danger of sepsis is past and the skin has healed, or is healing. Active and passive mobilization should then be instituted.

4. In cases of suppurative arthritis of the knee joint, potential or established, the same surgical plan is indicated.

5. Continuous drainage of fluid from the knee joint is not adequate surgical treatment in cases of suppurative arthritis; moreover, it is not indicated.

6. Systemic penicillin (at present the best available antibacterial agent), supplemented by the local instillation of penicillin into the joint, should be employed in patients with wounds and suppurative arthritis of the knee joint, in order to prevent invasive infection of the living tissue.

7. In the light of the problem and the hazards of knee-joint sepsis, knee-joint resection has a definite, but fortunately a limited, application in the management of severe wounds and sepsis of the knee joint in military surgery.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

    Topics

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe




    Related Articles
    Related Cases
    Related Content
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    jbjs jobs
    12/22/2011
    ME - Central Maine Medical Center
    12/22/2011
    VA - Charleston Area Medical Center
    12/22/2011
    Maine - Central Maine Medical Center