A manual of operative surgery . generally, flat,and forms an evensurface for the end ofthe stump. Thegroove between thefacet runs obliquelyfrom within forwardsand outwards. The following arethe ligaments betweenthe os calcis and as-tragalus. The mainconnection is effectedby the very massiveinterosseous ligament,which occupies the r FIG. 393,—OUTER AND INNER SIDES OF THE RIGHT FOOT, whole length of the TO show the incisions in farabeufs subastraga- groove. On the outer LOID AMreTAT1°N- . , . v, The lines of Verneuils subastragaloid amputation. (For Side are the mem- other references, see text.)
A manual of operative surgery . generally, flat,and forms an evensurface for the end ofthe stump. Thegroove between thefacet runs obliquelyfrom within forwardsand outwards. The following arethe ligaments betweenthe os calcis and as-tragalus. The mainconnection is effectedby the very massiveinterosseous ligament,which occupies the r FIG. 393,—OUTER AND INNER SIDES OF THE RIGHT FOOT, whole length of the TO show the incisions in farabeufs subastraga- groove. On the outer LOID AMreTAT1°N- . , . v, The lines of Verneuils subastragaloid amputation. (For Side are the mem- other references, see text.) branous external cal- caneo-astragaloid and external calcaneo-scaphoid ligaments, and apart of the external lateral ligament of the ankle. Behind is theposterior calcaneo-astragaloid ligament, and on the inner side theinternal ligament of that name, together with part of the internallateral ligament of the ankle. Position and Instruments.—The same as in the precedingoperation. The following methods will be described :—. 584 AMPUTATIONS [part vi 1. Farabeufs operation. 2. The oval operation. 3. Verneuils operation. 4. By the heel flap. 1. Farabeufs Operation by a Large Internal and PlantarFlap.—In this procedure a large flap is cut from the sole andthe inner aspect of the foot. (1) The Line of Incision.—The incision is commenced at theouter margin of the tendo Achillis at its insertion (Fig. 393, a),and is then curved up a little to reach the level of a point oneinch below^the outer malleolus. It is now carried forwardshorizontally, parallel to the outer border of the foot, and oneinch below the malleolus (a to b), and reaches a point (b) whichis on a line connecting the base of the fifth metatarsal bone withthe joints between the scaphoid and cuneiform bones. It thencurves sharply inwards across the dorsum of the foot (b to x), alittle in front of the joints named, and reaches the extensorproprius pollicis tendon at x. The incision next crosses the innerborder of th
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