. Operative surgery. Fig. 664.—Elastic ligature. strong forceps, separate the edges of the vertical incision, and remove theperiosteum with a suitable instrument down to the points of muscularinsertion. These must be separated with a knife, the edge directed towardthe bone. Eemove the periosteum in this manner up to the capsule ( Fig. 665.—Dieffenbachs circular method. 666), which is opened and the head dislocated. The last step of the opera-tion is attended with but slight loss of blood. Fig. 667 shows the appearanceof the parts after their coaptation. An additional drainage tube is inse
. Operative surgery. Fig. 664.—Elastic ligature. strong forceps, separate the edges of the vertical incision, and remove theperiosteum with a suitable instrument down to the points of muscularinsertion. These must be separated with a knife, the edge directed towardthe bone. Eemove the periosteum in this manner up to the capsule ( Fig. 665.—Dieffenbachs circular method. 666), which is opened and the head dislocated. The last step of the opera-tion is attended with but slight loss of blood. Fig. 667 shows the appearanceof the parts after their coaptation. An additional drainage tube is insertedat the lower extremity of the wound. If it be impossible to employ thebloodless method, the femoral vessels should be secured in two situations by37 554 OPERATIVE SURGERY. forceps or ligatures at the base of Scarpas triangle, and divided betweenthem (Fig. 665). Dieffenbaclis plan can be rapidly executed, and the lessened disturbanceof the soft parts attendant on removal of the periosteum is a desideratum. ^^^lil
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