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Updated: June 9, 2025
When hyperostosis and sclerosis of the bone is attended with severe pain which does not yield to blistering, the periosteum may be incised and the sclerosed bone perforated with a drill or trephine.
He had received several severe bites in the back and arms, but the worst wound was on the head, where the bear had struck him with his claws. His scalp was almost torn from his head, and a large piece of skull some three inches in diameter was broken out and lifted from the brain as cleanly as if done by the surgeon's trephine.
Treatment. If an abscess is suspected, there should be no hesitation in exploring the interior of the bone. It is exposed by a suitable incision; the periosteum is reflected and the bone is opened up by a trephine or chisel, and the presence of an abscess may be at once indicated by the escape of pus.
If the arrow passes entirely through the head, and the results are not immediately fatal, he directs the surgeon to enlarge the wound of exit with a trephine, remove the arrowhead through this opening, and withdraw the shaft of the arrow through the wound of entrance.
Clinical experience is conclusive that a portion of bone which has been completely detached from its surroundings for example, a trephine circle, or a flap of bone detached with the saw, or the loose fragments in a compound fracture may become, if replaced in position, firmly and permanently incorporated with the surrounding bone.
The right parietal bone was dented very slightly for a space nearly as broad as a penny. The skin was broken, but the bone itself, though depressed slightly, was not destroyed. The inner table of the skull no doubt was splintered, hence the brain mischief. There was only one thing to be done trephine. And that as swiftly as possible.
"Your star above mine," said Fu-Manchu, his calm unruffled. "I place myself in your hands, Sir Baldwin." Assisted by his unemotional compatriot, Fu-Manchu discarded the yellow robe, revealing himself in a white singlet in all his gaunt ugliness, and extended his frame upon the operating-table. Li-King-Su ignited the large lamp over the head of the table, and from his case took out a trephine.
In cases of thickening of the bone with persistent and severe pain, if relief is not afforded by the repeated application of blisters, the thickened periosteum should be incised, and the bone opened up with the chisel or trephine. In cases attended with suppuration, the swelling is incised and drained, and if there is a sequestrum, it must be removed.
It was round, the end of his index finger entered it readily, and it was just such an opening as would have been produced by the crown of a trephine. At the time it was made, the skin opened to allow of the exit of the pieces of bone; then it closed without leaving the trace of a scar. It was the same with the stigmata.
It is a trephine, a surgical implement for cutting round pieces out of broken skulls, so as to get at the fragments which have been driven in, and lift them up. It has a handle like that of a gimlet, with a claw like a hammer, to lift with, I suppose, which last contrivance I do not see figured in my books.
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