. Minor and operative surgery, including bandaging . Division of muscles in circular amputation. (Smith.) Transfixion Method.—This is a variety of the flapmethod, the flaps being cut from within outward ; they maybe lateral or antero-posterior. In amputating by this methodthe surgeon grasps the limb and enters the point of a longknife into the tissues at the side nearest himself, and push- MODIFIED CIRCULAR OR OVAL METHOD. 483 ing it across and round the bone or bones brings its pointout through the skin at a point diametrically opposite itspoint of entrance. He then shapes the flap by cutting
. Minor and operative surgery, including bandaging . Division of muscles in circular amputation. (Smith.) Transfixion Method.—This is a variety of the flapmethod, the flaps being cut from within outward ; they maybe lateral or antero-posterior. In amputating by this methodthe surgeon grasps the limb and enters the point of a longknife into the tissues at the side nearest himself, and push- MODIFIED CIRCULAR OR OVAL METHOD. 483 ing it across and round the bone or bones brings its pointout through the skin at a point diametrically opposite itspoint of entrance. He then shapes the flap by cuttingdownward with a rapid sawing motion, and then cutsobliquely forward until all the tissues are divided. Theflap being turned up, he re-enters his knife at the samepoint and passes it on the other side of the bone or bonesand cuts the second flap in the same manner (Fig. 375). Aretractor is next applied and the bone is divided with a saw. Fig. Amputation by antero-posterior flaps. (Bryant.) Modified Circular or Oval Method.—In this form ofamputation two oval antero-posterior or lateral flaps ofskin are marked out by incisions and dissected up to thepoint at which the muscles and bone are to be muscles are then divided close to the base of the flapsby a circular sweep of the knife, and the operation iscompleted by sawing the bones. This form of amputationis at present widely employed, and is especially to be recom-mended in muscular limbs (Fig. 376). Elliptical Method. —This is a form of the oval methodof amputation which is employed in amputations at theknee-joint and elbow-joint, the incision forming an ellipse, 484 376.
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