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Following the lead of Mikulicz, a considerable number of permanent cures have been obtained by resecting the portion of bone which is the seat of the tumour, and substituting for it a corresponding portion from the tibia or fibula of the other limb. In a cellular sarcoma of the humerus of a boy we resected the shaft and inserted his fibula ten years ago, and he shows no sign of recurrence.
Marshall thought that the operation of resecting the leg at the hip might save his life, and though such a maimed existence as his would then be was but a doubtful boon, the boy eagerly caught at the chance of life; and, to recruit strength for the operation, I decided to take him, by Marshall's advice, to America, and give him a summer in the woods, camping out.
In the living subject, by using a fine needle-like electrode and a very weak galvanic current, he has been able to differentiate the nerve bundles for the various groups of muscles. In several cases of spastic paralysis he succeeded in picking out in the nerve-trunk of the affected limb the nerve bundles supplying the spastic muscles, and, by resecting portions of them, in relieving the spasm.
In inoperable cases it may be possible to relieve pain by excising a portion of the nerve above the tumour, or, when this is impracticable, by resecting the posterior nerve roots and their ganglia within the vertebral canal. Diffuse or Generalised Neuro-Fibromatosis Recklinghausen's Disease.
Attempts have been made to interrupt the channel along which the infective emboli spread, by ligating or resecting the main vein of the affected part, but this is seldom feasible except in the case of the internal jugular vein for infection of the transverse sinus. Secondary abscesses must be aspirated or opened and drained whenever possible.
A new sheath may be provided for the tendon by resecting a portion of the great saphenous vein. Injuries of the tendons of the fingers are comparatively common. One of the best known is the partial or complete rupture of the aponeurosis of the extensor tendon close to its insertion into the terminal phalanx drop- or mallet-finger.
The operation of Trendelenburg is especially appropriate to cases in which the trunk of the great saphena vein in the thigh is alone involved. It consists in exposing three or four inches of the vein in its upper part, applying a ligature at the upper and lower ends of the exposed portion, and, after tying all tributary branches, resecting this portion of the vein.
In some cases benefit has followed the prolonged internal administration of liquid paraffin. On the assumption that the condition is the result of an auto-intoxication from the intestinal tract, saline purges and irrigation of the colon are indicated, and Arbuthnot Lane claims to have brought about improvement by short-circuiting or by resecting the colon.
When medical treatment fails, the nerve-trunks may be injected with saline solution or recourse may be had to operative measures, the affected cords being exposed and stretched through an incision in the posterior triangle of the neck. If this fails to give relief, the more serious operation of resecting the posterior roots of the affected nerves within the vertebral canal may be considered.
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