A manual of operative surgery . s shouldtake place from below upwards. Itmay be noted that the flexor sublimis atthe middle third of the forearm presentsa few fine commencing tendon fibres. In muscular subjects care should betaken that the incision is made longenough. It is only by the display of greatcarelessness that it would be possibleto open up the interspace between theflexor sublimis and palmaris longusmuscles. When the proper interval has been found between the flexorsublimis and the flexor carpi ulnaris, it is not uncommon for thebeginner—impressed with erroneous views as to the depth
A manual of operative surgery . s shouldtake place from below upwards. Itmay be noted that the flexor sublimis atthe middle third of the forearm presentsa few fine commencing tendon fibres. In muscular subjects care should betaken that the incision is made longenough. It is only by the display of greatcarelessness that it would be possibleto open up the interspace between theflexor sublimis and palmaris longusmuscles. When the proper interval has been found between the flexorsublimis and the flexor carpi ulnaris, it is not uncommon for thebeginner—impressed with erroneous views as to the depths of theartery—to proceed too deeply and too far to the inner side, and toactually pass by the ulnar nerve and open,up the interspace betweenthe flexor carpi ulnaris and the flexor profundus digitorum. (SeeFig- 319, b.) This may readily happen if the former muscle be draggedtoo much to the inner side. Collateral Circulation after Ligature of the Radial orUlnar Artery.—After ligature of one of these vessels, the collateral. FIG. 318.—LIGATURE OF RIGHTULNAR ARTEKY AT THE MIDDLETHIRD OF THE FOREARM. Deep Wound. — a, Fascia ; B,Flex, sublimis; C, FJex. carp,ulnaris ; D, Flex, profundus ; a,Artery; I, Ulnar nerve. 352 OPERATIONS ON ARTERIES [part V 2-- circulation is very readilyand freely established,through the cross anasto-moses between the arteriesin question, through thepalmar and carpal arches,and through the inter-osseous vessels. Varieties of the Radialand Ulnar Arteries. i. The radial has beenfound outside the fascia,and subcutaneous. 2. The ulnar may besubcutaneous or subfascialin its entire course. 3. The median arterymay be of large size and be largely concerned in the supply of the palm. 4. The radial artery may be absent.
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Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
