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Chapter One1

WOUND HEALING＆In collaboration with J．Englebert Dunphy,M．D．1

Chapter Two22

WOUND MANAGEMENT22

Chapter Three47

GRAFTING AND SUBSTITUTION＆In collaboration with Richard E．Wilson,M．D．,and Joseph E．Murray,M．D．47

Chapter Four74

THE SYSTEMIC EFFECTS OF TRAUMA＆In collaboration with Francis D．Moore,M．D．74

Chapter Five100

VISCERAL DISEASE IN SURGICAL PATIENTS100

Gastrointestinal Tract100

Respiratory Tract126

Cardiovascular System139

Liver145

Endocrine System149

Urinary Tract158

Coagulation Mechanism166

Chapter Six176

THERAPY:ENTERAL AND PARENTERAL＆In collaboration with Francis D．Moore,M．D．176

Chapter Seven203

BURNS＆In collaboration with Francis D．Moore,M．D．203

Chapter Eight221

INFECTIONS221

Chapter Nine251

TUMORS251

Chapter Ten276

ANESTHESIA＆In collaboration with Leroy D．Vandam,M．D．276

Chapter Eleven314

THE BRAIN＆Contributed by William H．Sweet,M．D．314

Chapter Twelve370

THE SPINAL CORD＆Contributed by Donald D．Matson,M．D．370

Chapter Thirteen403

THE PERIPHERAL NERVES＆Contributed by Donald D．Matson,M．D．403

Chapter Fourteen420

PAIN＆Contributed by James C．White,M．D．420

Chapter Fifteen442

THE EYE＆Contributed by Garrett L．Sullivan,M．D．442

Chapter Sixteen472

THE EAR＆Contributed by Donald K．Lewis,M．D．472

Chapter Seventeen498

THE NOSE,SINUSES,AND NASOPHARYNX＆Contributed by John R．Richardson,M．D．498

Chapter Eighteen518

THE PHARYNX,HYPOPHARYNX,AND LARYNX＆Contributed by George F．Reed,M．D．518

Chapter Nineteen542

THE FACE,MOUTH,AND JAWS＆Contributed by Joseph E．Murray,M．D．542

Chapter Twenty563

THE THYROID AND PARATHYROID＆Contributed by Oliver Cope,M．D．563

The Thyroid563

The Parathyroid581

Chapter Twenty-One598

CHEST WALL,LUNGS,AND MEDIASTINUM＆Contributed by J．Gordon Scannell,M．D．598

Chapter Twenty-Two650

THE HEART650

Chapter Twenty-Three691

THE ESOPHAGUS AND DIAPHRAGM＆Contributed by George L．Nardi,M．D．691

The Esophagus691

The Diaphragm710

Chapter Twenty-Four717

THE BREAST＆Contributed by Andrew G．Jessiman,M．D．717

Chapter Twenty-Five744

THE GASTROINTESTINAL TRACT AND THE ACUTE ABDOMEN＆Contributed by Francis D．Moore,M．D．744

Chapter Twenty-Six824

LIVER,BILIARY TRACT,PANCREAS,AND SPLEEN＆Contributed by William V．McDermott,M．D．824

Liver824

Biliary Tract840

Pancreas852

Spleen867

Chapter Twenty-Seven879

HERNIA AND THE ABDOMINAL WALL879

Chapter Twenty-Eight901

THE GENITOURINARY TRACT AND ADRENALS＆Contributed by J．Hartwell Harrison,M．D．901

Genitourinary Tract901

Adrenal Gland948

Chapter Twenty-Nine960

THE FEMALE REPRODUCTIVE TRACT＆Contributed by Somers H．Sturgis,M．D．960

Chapter Thirty1002

ARTERIES,VEINS,AND LYMPHATICS1002

Arteries1005

Veins1038

Lymphatics1048

Chapter Thirty-One1058

THE MUSCULOSKELETAL SYSTEM＆Contributed by William T．Green,M．D．,and Mihran O．Tachdjian,M．D．1058

Orthopedic Principles and Methods1058

Congenital Deformities1075

Bone1087

Joints1121

Muscles,Tendons,Bursae,and the Neuromuscular System1143

The Hand1166

The Spine and Pelvis1189

The Foot1199

Chapter Thirty-Two1217

FRACTURES,DISLOCATIONS,AND SPRAINS＆Contributed by Thomas B．Quigley,M．D．1217

Chapter Thirty-Three1267

EXTENSIVE TRAUMA1267

Chapter Thirty-Four1283

NEONATAL SURGERY＆Contributed by W．Hardy Hendren,M．D．1283

INDEX OF NAMES1347

INDEX OF SUBJECTS1365

List of Jllustrations3

Figure 1．Granulation tissue3

Figure 2．Rate of epithelization4

Figure 3．Gillman＇s concept of epithelial migration5

Figure 4．Wound contraction6

Figure 5．Hexosamine,chondroitin sulfate and collagen formation in the healing wound9

Figure 6．Tensile strength of experimental wounds in different tissues10

Figure 7．Structural process of bone healing12

Figure 8．Wallerian degeneration12

Figure 9．Effect of methionine on wounds in protein-starved rats16

Figure 10．Keloid formation18

Figure 11．Types of wound25

Figure 12．Cavitation in missile tract26

Figure 13．Contrecoup trauma26

Figure 14．Wound excision29

Figure 15．Delayed primary closure30

Figure 16．Secondary closure32

Figure 17．Methods of suturing certain tissues36

Figure 18．Z-plasty38

Figure 19．Skin grafts40

Figure 20．Pedicle flap41

Figure 21．One type of dressing for a skin graft43

Figure 22．Dressing technique44

Figure 23．The transplanted kidney in situ50

Figure 24．Immunologic principles of skin homograft rejection in man52

Figure 25．Demonstration of＂cell-bound＂antibodies57

Figure 26．Acquired tolerance and-adoptive immunity59

Figure 27．Homograft rejection reaction60

Figure 28．The millipore filter chamber in vivo64

Figure 29．Homograft take in irradiated rabbit65

Figure 30．Closed elective soft tissue operation of moderate severity76

Figure 31．Nitrogen balance,caloric intake,and weight following trauma77

Figure 32．Weight-curves in several settings80

Figure 33．Alterations in coagulation factors postoperatively82

Figure 34．Varying degrees of trauma85

Figure 35．Activation of volume conservation86

Figure 36．The various stages of progression of shock90

Figure 37．Factors affecting contractility and irritability in heart and artery96

Figure 38．Effect of definitive operation on severe injury96

Figure 39．Blood supply to the intestinal wall103

Figure 40．Sites of fluid loss in intestinal obstruction103

Figure 41．Visible peristalsis107

Figure 42．Distribution of gas shadows in small and large intestinal obstruction109

Figure 43．Intestinal intubation110

Figure 44．Two forms of small bowel obstruction112

Figure 45．Duodenal fistula118

Figure 46．Appearance of experimental starvation120

Figure 47．Lung volumes127

Figure 48．Emphysema and barrel chest130

Figure 49．Relationship of vital capacity to maximum breathing capacity131

Figure 50．Estimate of＂operative risk＂on the basis of pulmonary function132

Figure 51．Cardiorespiratory factors associated with operation133

Figure 52．Causes of retained secretions134

Figure 53．Effects of tracheostomy on ventilatory factors136

Figure 54．Intermittent positive pressure breathing with tracheostomy137

Figure 55．Electrocardiographic evidence of changes in serum potassium141

Figure 56．Some cardiac arrhythmias occurring after operation143

Figure 57．Hepatic failure147

Figure 58．Adrenocortical steroids149

Figure 59．Adrenal failure152

Figure 60．Arterial calcification in the diabetic156

Figure 61．Pathogenesis of renal failure161

Figure 62．Calcific embolus to kidney162

Figure 63．Acute renal failure162

Figure 64．The artificial kidney164

Figure 65．The coagulation mechanism170

Figure 66．Fibrinolytic purpura171

Figure 67．Intravenous infusion－special techniques178

Figure 68．Plasma storage186

Figure 69．Processing of blood for frozen storage192

Figure 70．Major group crossmatching of blood193

Figure 71．Flow sheet of safe transfusion195

Figure 72．Deterioration of blood in the bank196

Figure 73．Classification of burns according to depth204

Figure 74．The Rule of Nines205

Figure 75．Body composition in burns207

Figure 76．Major burns － weight changes209

Figure 77．Exposure treatment of the burn wound213

Figure 78．Metabolic events after an extensive burn217

Figure 79．Fourth degree burns218

Figure 80．Loss of function due to infection227

Figure 81．Fluctuation230

Figure 82．Testing of sensitivity of organism to antibacterial drugs232

Figure 83．Carbuncle234

Figure 84．Four types of temperature chart236

Figure 85．Pseudomembranous enterocolitis237

Figure 86．Tetanus240

Figure 87．Modern autoclave245

Figure 88．Effect of scrubbing on the bacteria count246

Figure 89．Experimental cancer253

Figure 90．Avenues of spread of cancer255

Figure 91．Classification of grade of cancer257

Figure 92．Types of biopsy259

Figure 93．Papanicolaou vaginal smears260

Figure 94．Radiation dermatitis265

Figure 95．Radiotherapy of lymphoma267

Figure 96．Limb perfusion271

Figure 97．Local infiltration and field block282

Figure 98．Nerve block283

Figure 99．Spinal anesthesia284

Figure 100．Anesthesia machine286

Figure 101．Endotracheal intubation287

Figure 102．Static electricity293

Figure 103．Hypothermia induced by refrigerated blankets296

Figure 104．Pump oxygenator298

Figure 105．Signs and stages of anesthesia305

Figure 106．Cardiac massage (manual systole)308

Figure 107．Artificial respiration310

Figure 108．Paravertebral lumbar block311

Figure 109．Papilledema316

Figure 110．Herniations of the brain317

Figure 111．Sites of origin of motor,sensory,and psychic seizures319

Figure 112．Loudness balance test324

Figure 113．Changes in skull evoked by increased intracranial pressure327

Figure 114．Electroencephalographic localization of focal intracranial lesion328

Figure 115．Isotopic encephalography330

Figure 116．Normal cerebral angiogram331

Figure 117．Pneumoencephalogram332

Figure 118．Ventriculoatriostomy and ventriculocisternostomy335

Figure 119．Traumatic intracranial hematomas338

Figure 120．Subdural hematoma339

Figure 121．Glioblastoma multiforme343

Figure 122．Craniopharyngioma346

Figure 123．Acoustic neurinoma348

Figure 124．Intracranial aneurysm351

Figure 125．Arteriovenous malformation353

Figure 126．Position for unconscious patient362

Figure 127．Lumbar puncture373

Figure 128．Cistern puncture374

Figure 129．Spina bifida376

Figure 130．Arnold-Chiari malformation378

Figure 131．Preferred position for transporting patient with cervical spine injury381

Figure 132．Compression fracture of vertebra383

Figure 133．Fracture-dislocation of C4 and C5384

Figure 134．Decubitus ulcers386

Figure 135．Tidal drainage387

Figure 136．Rehabilitation in paraplegia388

Figure 137．Patient with ruptured intervertebral disc on left391

Figure 138．Rupture of intervertebral lumbar disc－myelogram392

Figure 139．Rupture of intervertebral cervical disc394

Figure 140．Tumor of cauda equina396

Figure 141．Extradural sarcoma398

Figure 142．Radial nerve division above elbow410

Figure 143．Median nerve division above elbow410

Figure 144．Ulnar nerve division411

Figure 145．Common peroneal nerve division412

Figure 146．Tibial nerve division412

Figure 147．Erb＇s palsy414

Figure 148．Brachial plexus stretch injury414

Figure 149．Posterior spinal root section421

Figure 150．Retrogasserian rhizotomy by temporal approach422

Figure 151．Sectioning trigeminal and glossopharyngeal nerves423

Figure 152．Anterolateral cordotomy424

Figure 153．The cardiac nerves431

Figure 154．Upper thoracic sympathetic ganglionectomy432

Figure 155．Dorsal and lumbar sympathetic ganglionectomy and splanchnicectomy433

Figure 156．The globus oculi445

Figure 157．Perforating wound of globe449

Figure 158．Removal of intraocular foreign body450

Figure 159．The eyelid452

Figure 160．Chalazion453

Figure 161．Basal cell carcinoma of lower lid454

Figure 162．Pterygium456

Figure 163．The lacrimal apparatus458

Figure 164．Glaucoma462

Figure 165．Cataract464

Figure 166．Cataract extraction465

Figure 167．Melanotic sacroma with associated detachment of the retina466

Figure 168．Medial wall of tympanic cavity474

Figure 169．Audiogram478

Figure 170．Acute otitis media483

Figure 171．Mastoiditis－x-ray486

Figure 172．Endaural incisions488

Figure 173．Mastoidectomy488

Figure 174．Types of tympanoplasty489

Figure 175．Fenestration operation before closing of cavity492

Figure 176．Directional forces for mobilizing the stapes493

Figure 177．Stapedectomy plus prosthetic replacement494

Figure 178．External nose－structure and relationships500

Figure 179．Nasal septum502

Figure 180．Nasal septum － arterial blood supply503

Figure 181．Posterior nasal plug505

Figure 182．Lateral nasal wall506

Figure 183．Lateral nasal wall508

Figure 184．Coronal section through nose509

Figure 185．Pathway of spread of infection from acute frontal sinusitis510

Figure 186．Maxillary sinus511

Figure 187．Pharyngeal abscesses － typical locations521

Figure 188．Two views of the larynx527

Figure 189．Technique of mirror laryngoscopy527

Figure 190．Emergency tracheostomy531

Figure 191．Chronic disorders of the larynx534

Figure 192．Arytenoidectomy536

Figure 193．Laryngocele538

Figure 194．Laryngectomy540

Figure 195．Distribution of cervical lymph nodes544

Figure 196．Severe complete bilateral harelip545

Figure 197．Prognathism546

Figure 198．Hemangioma in a child546

Figure 199．Macroglossia547

Figure 200．Usual sites of fracture in the mandible549

Figure 201．Usual fracture lines of mid-third of face550

Figure 202．Facial expression lines553

Figure 203．Malignant melanoma554

Figure 204．Carcinoma of upper lip555

Figure 205．Intraoral cancer556

Figure 206．Metastatic epidemoid carcinoma in neck node557

Figure 207．Mixed tumor of the parotid560

Figure 208．The control of thyroid function565

Figure 209．The motor nerves to the larynx568

Figure 210．The postulated sequence in development of nodular goiter574

Figure 211．Lymph node areas577

Figure 212．Distribution of bony involvement in fibrous dysplasia of bone588

Figure 213．Distribution of parathyroid glands590

Figure 214．Water-clear cell hyperplasia591

Figure 215．Chief-cell hyperplasia591

Figure 216．Mediastinal parathyroid adenomas594

Figure 217．Blood serum calcium and phosphorus levels595

Figure 218．Surface landmarks of chest600

Figure 219．Funnel chest602

Figure 220．Pendulum air604

Figure 221．Traumatic asphyxia605

Figure 222．Subcutaneous emphysema606

Figure 223．Two forms of closed chest drainage607

Figure 224．Model simulating pleural pressures611

Figure 225．Types of pneumothorax612

Figure 226．Mechanical forces at play on a localized empyema cavity613

Figure 227．Segmental anatomy of the lung617

Figure 228．Lymphatic drainage of the lung620

Figure 229．Emphysematous blebs and pneumothorax622

Figure 230．Bronchographic anatomy and bronchiectasis628

Figure 231．Tuberculosis of the lung631

Figure 232．Radiologic manifestations of cancer of the lung638

Figure 233．Distant metastases of cancer of the lung639

Figure 234．Operability and survival after resection of cancer of lung642

Figure 235．Neurofibroma of the mediastinum645

Figure 236．Right heart catheterization652

Figure 237．Left heart catheterization652

Figure 238．Pressures and oxygen saturations of the blood in normal heart653

Figure 239．Pulse contours and pressures in heart chambers654

Figure 240．X-ray views of the heart657

Figure 241．Fetal circulation658

Figure 242．Patent ductus arteriosus unaccompanied by pulmonary arterial hypertension659

Figure 243．Patent ductus arteriosus with pulmonary arterial hypertension659

Figure 244．Heart of 10 mm．embryo661

Figure 245．Interatrial septal defect662

Figure 246．Interventricular septal defect of moderately large size664

Figure 247．Pulmonic valvular stenosis with intact interventricular septum666

Figure 248．Tetralogy of Fallot－moderate cyanosis667

Figure 249．Tetralogy of Fallot－characteristic squatting position667

Figure 250．Tetralogy of Fallot－available operative procedures668

Figure 251．Congenital valvular aortic stenosis669

Figure 252．Complete transposition of great arteries670

Figure 253．Cardiac wound with tamponade671

Figure 254．Mitral stenosis,moderately severe672

Figure 255．Mitral stenosis674

Figure 256．Calcific aortic stenosis677

Figure 257．Aortic insufficiency680

Figure 258．Aortic insufficiency680

Figure 259．Coronary arteriosclerosis684

Figure 260．Constrictive pericarditis685

Figure 261．Spontaneous rupture of the esophagus694

Figure 262．Development of a pharyngeal diverticulum696

Figure 263．X-ray appearance of pharyngeal diverticulum697

Figure 264．X-ray appearance of lower esophageal ring698

Figure 265．Caustic stenosis699

Figure 266．Types of esophageal reconstruction700

Figure 267．Leiomyoma of the esophagus701

Figure 268．Operative removal of leiomyoma of the esophagus701

Figure 269．Carcinoma of esophagus,x-ray appearance702

Figure 270．Esophagospasm704

Figure 271．Gastritis and gastroesophageal reflux706

Figure 272．Achalasia of the esophagus707

Figure 273．The Heller procedure708

Figure 274．Sliding hiatus hernia711

Figure 275．Sliding hiatus hernia711

Figure 276．Hormonal factors influencing the breast719

Figure 277．Examination of the axilla720

Figure 278．Physical signs of benign and malignant tumors722

Figure 279．Drainage of breast abscess724

Figure 280．Spread of breast cancer729

Figure 281．Histologic types of breast carcinoma730

Figure 282．Clinical stages 1 and 2 of breast carcinoma733

Figure 283．Radical mastectomy734

Figure 284．Operative field at the completion of dissection735

Figure 285．Clinical stage 3 of breast carcinoma737

Figure 286．Carcinoma of the stomach752

Figure 287．Carcinoma of the stomach754

Figure 288．Duodenal ulcer756

Figure 289．Gastric outlet obstruction759

Figure 290．Ulcer surgery in search of a rationale763

Figure 291．The stomach as an＂osmotic shield＂768

Figure 292．Large benign gastric ulcer770

Figure 293．Leiomyoma of the stomach774

Figure 294．Duodenal polyp774

Figure 295．Regional enteritis777

Figure 296．Carcinoid of the small bowel780

Figure 297．Acute appendicitis784

Figure 298．Carcinoma of the colon in congenital polyposis789

Figure 299．Lymphatics of the colon793

Figure 300．Operations for carcinoma of the colon794

Figure 301．Ulcerative colitis799

Figure 302．Exteriorization of the gastrointestinal tract801

Figure 303．Diverticulitis of the sigmoid803

Figure 304．Anatomy of anus807

Figure 305．Hemorrhoids809

Figure 306．Perianal and perineal fistulas811

Figure 307．Prolapse of the rectum and enterocele813

Figure 308．The major types of portal cirrhosis826

Figure 309．Pathogenesis of ascites828

Figure 310．Ammonia metabolism829

Figure 311．Arterial spider830

Figure 312．Esophageal varices－x-ray831

Figure 313．Splenoportography832

Figure 314．Balloon tamponade of esophageal and gastric varices832

Figure 315．Types of porto-systemic shunt834

Figure 316．Relief of ascites by portacaval shunt836

Figure 317．Bilirubin metabolism841

Figure 318．Pathogenesis of acute cholecystitis845

Figure 319．Common duct stones847

Figure 320．Operative cholangiogram849

Figure 321．Operations for pancreatitis858

Figure 322．Carcinoma of head of the pancreas860

Figure 323．Whipple operation (pancreaticoduodenal resection for cancer)861

Figure 324．The surgical treatment of pseudocyst of the pancreas863

Figure 325．Traumatic rupture of spleen868

Figure 326．Platelet response to splenectomy873

Figure 327．Sites of hernia881

Figure 328．Sliding hernia881

Figure 329．Varix simulating hernia886

Figure 330．Some hernia repairs889

Figure 331．Reduction of hernia by taxis890

Figure 332．Incisional hernia892

Figure 333．Interstitial hernia892

Figure 334．Langer＇s lines of skin elasticity895

Figure 335．Abdominal incisions896

Figure 336．Polycystic disease904

Figure 337．Horseshoe kidney905

Figure 338．Ectopic pelvic kidney905

Figure 339．Congenital hydronephrosis906

Figure 340．Duplication of ureter and pelvis907

Figure 341．Trauma to the kidney909

Figure 342．Pyelonephritis912

Figure 343．Renal cortical abscess913

Figure 344．Bilateral urinary calculi918

Figure 345．Renal carcinoma920

Figure 346．Renal hypertension924

Figure 347．Rupture of bladder926

Figure 348．Lymphatic drainage of pelvic organs928

Figure 349．Ruptured urethra931

Figure 350．The hypertrophied prostate933

Figure 351．Carcinoma of prostate with metastases936

Figure 352．Hydrocele of tunica vaginalis943

Figure 353．Torsion of spermatic cord943

Figure 354．Tumor of the testis946

Figure 355．Virilizing adrenal tumor950

Figure 356．Hyperadrenocorticism952

Figure 357．Common locations for pheochromocytoma953

Figure 358．Catecholamines in pheochromocytoma954

Figure 359．Congenital anomalies of the uterus964

Figure 360．Ovarian dysgenesis965

Figure 361．Female pseudohermaphroditism966

Figure 362．Congenital eversion of the cervix967

Figure 363．Retrodisplacement of the uterus968

Figure 364．Pessaries for retrodisplacement970

Figure 365．Acute bartholinitis973

Figure 366．Monilia975

Figure 367．Endocervical polyp977

Figure 368．Multiple uterine fibroids977

Figure 369．Calcified fibroid978

Figure 370．Schiller test979

Figure 371．Conization of the cervix980

Figure 372．League of Nations staging of cancer of cervix981

Figure 373．Operative specimen of Stage IV cancer of cervix removed by pelvic exenteration982

Figure 374．Uterogram982

Figure 375．Culdoscopy984

Figure 376．The＂fern＂test990

Figure 377．Stein-Leventhal syndrome992

Figure 378．Cystic and adenomatous hyperplasia of endometrium993

Figure 379．Endometriosis as seen at laparotomy995

Figure 380．Raynaud＇s disease1006

Figure 381．Skin temperatures in various states of sympathetic tone1008

Figure 382．Frostbite1010

Figure 383．Sources of arterial embolism1012

Figure 384．Sites of arterial embolism1013

Figure 385．Method of testing for oscillations1014

Figure 386．Arterial contusion and spasm1017

Figure 387．False aneurysm1017

Figure 388．Coarctation of the aorta1019

Figure 389．Arteriograms1020

Figure 390．Arteriosclerotic gangrene of the forefoot1021

Figure 391．Aortopopliteal bypass graft1022

Figure 392．Stenosis of extracranial internal carotid artery1024

Figure 393．Phlebitis migrans1026

Figure 394．Levels of amputation1029

Figure 395．The Syme amputation1030

Figure 396．Initial prostheses for below knee and above knee amputations1031

Figure 397．Abdominal aortic arteriosclerotic aneurysm1032

Figure 398．Dissecting aneurysm of the aorta1034

Figure 399．Arteriovenous fistula1035

Figure 400．Venous circulation in normal and diseased legs1040

Figure 401．Post-phlebitic syndrome1041

Figure 402．Tests for function of the deep veins1042

Figure 403．Superior vena caval syndrome1043

Figure 404．Loose thrombus in femoral vein1045

Figure 405．Pulmonary embolus1047

Figure 406．Congenital lymphedema1048

Figure 407．Elephantiasis1049

Figure 408．Lymphangiography1050

Figure 409．Testing for deformities1061

Figure 410．Testing for range of motion1063

Figure 411．Plaster of Paris body cast1066

Figure 412．Two kinds of brace1068

Figure 413．Russell traction1069

Figure 414．Epiphyseal arrest1071

Figure 415．Congenital muscular torticollis1076

Figure 416．Sprengel＇s deformity1077

Figure 417．Talipes equinovarus1080

Figure 418．Congenital dislocation of left hip1085

Figure 419．Arthrogryposis multiplex congenita1086

Figure 420．Wolff＇s law1087

Figure 421．Deformity due to muscle action1088

Figure 422．Growth prediction chart1090

Figure 423．Epiphyseal injury1091

Figure 424．Osteomyelitis1093

Figure 425．Legg-Perthes disease1097

Figure 426．Patten bottom brace1097

Figure 427．Slipped capital femoral epiphysis1099

Figure 428．Osteochondroma of the proximal tibia1106

Figure 429．Giant cell tumor of the distal radius1108

Figure 430．Solitary bone cyst1109

Figure 431．Osteoid osteoma of the femur1111

Figure 432．Eosinophilic granuloma of the illium1112

Figure 433．Osteogenic sarcoma of the femur1114

Figure 434．Ewing＇s sarcoma1117

Figure 435．Metastatic carcinoma with pathological feature1120

Figure 436．Pyogenic arthritis1124

Figure 437．Pott＇s disease1127

Figure 438．Tuberculosis of the hip1127

Figure 439．Malum coxae senilis1131

Figure 440．Internal derangement of the knee1134

Figure 441．Tear of the medial meniscus1136

Figure 442．Tear of the cruciate ligaments1137

Figure 443．Tear of the medial collateral ligament1138

Figure 444．Volkmann＇s contracture1147

Figure 445．Calcareous tendonitis1152

Figure 446．Poliomyelitis － myostatic contractures and fixed deformities1155

Figure 447．Poliomyelitis － transplantation of peroneus longus tendon1158

Figure 448．Poliomyelitis － varus deformity1159

Figure 449．Poliomyelitis－pes planovalgus1160

Figure 450．Birth palsy1164

Figure 451．Correct incisions in the hand1168

Figure 452．Splinting of the hand1178

Figure 453．Felon1179

Figure 454．Paronychia1180

Figure 455．Dupuytren＇s contracture1185

Figure 456．Posture1189

Figure 457．Scoliosis1191

Figure 458．Corsets and braces1196

Figure 459．Pronated feet1200

Figure 460．Hallux valgus (bunion)1203

Figure 461．Types of fracture (open＂compound＂fracture)1218

Figure 462．Types of fractures－transverse,comminuted,spiral,greenstick1219

Figure 463．Types of fractures－impacted,compression1219

Figure 464．The Thomas splint1222

Figure 465．External skeletal fixation1226

Figure 466．Fracture of the clavicle1228

Figure 467．Fracture of the clavicle1229

Figure 468．Acromioclavicular ligament injury1230

Figure 469．Dislocation of the shoulder1232

Figure 470．Fracture of the proximal humerus1233

Figure 471．Fracture of the shaft of the humerus1234

Figure 472．Myositis ossificans1235

Figure 473．Fracture of humerus at elbow1236

Figure 474．Fracture of the head of the radius1237

Figure 475．Fracture of olecranon and elbow dislocation1237

Figure 476．Monteggia fracture and shattered elbow1238

Figure 477．Fracture of both bones of forearm1239

Figure 478．Fracture of distal radial epiphysis1240

Figure 479．Fracture of the scaphoid1241

Figure 480．Colles＇ fracture1242

Figure 481．Fracture of the metacarpals1243

Figure 482．Fracture of the neck of the metacarpal1244

Figure 483．Compression fracture of the lumbar spine1246

Figure 484．Fracture of the pelvis1247

Figure 485．Posterior dislocation of the hip1249

Figure 486．Fracture of the hip1251

Figure 487．Fracture of femur1253

Figure 488．The effect of violent abduction on the knee1254

Figure 489．Fracture of the patella1255

Figure 490．Fracture of tibia and fibula1257

Figure 491．Ankle injuries1259

Figure 492．Micrognathia1289

Figure 493．Cystic hygroma1290

Figure 494．Bronchial compression1292

Figure 495．Staphylococcal pneumonia1293

Figure 496．Esophageal atresia and fistula1295

Figure 497．Esophageal atresia－x-ray1296

Figure 498．Diaphragmatic hernia1298

Figure 499．Ileal atresia1300

Figure 500．Esophageal stenosis1300

Figure 501．Types of intestinal atresia1303

Figure 502．Mikulicz resection technique1305

Figure 503．Malrotation of the intestine1307

Figure 504．Hirschsprung＇s disease1309

Figure 505．Ileocecal duplication1312

Figure 506．Inguinal hernia1313

Figure 507．Pneumoperitoneum1314

Figure 508．Large sacrococcygeal teratoma1317

Figure 509．Torsion of ovarian cyst in newborn1319

Figure 510．Large omphalocele1326

Figure 511．Anatomy of adrenogenital syndrome1332