. Medical and surgical therapy . out sayingthat arterial suture is here quite superfluous. Diffuse haematoma of the antero-external regionof the leg due to injury of the anterior tibial is asrare as diffuse haematoma of the calf is have, however, seen two or three such cases. Thehaematoma developed in both the antero-external andposterior regions of the leg as the result of a largeperforation of the interosseous membrane by theprojectile. In such a case it is extremely difficult 258 ]yOl\\DS OF THE VESSELS to diagnose the wounded vessel in advance. It willbe remembered that the ante
. Medical and surgical therapy . out sayingthat arterial suture is here quite superfluous. Diffuse haematoma of the antero-external regionof the leg due to injury of the anterior tibial is asrare as diffuse haematoma of the calf is have, however, seen two or three such cases. Thehaematoma developed in both the antero-external andposterior regions of the leg as the result of a largeperforation of the interosseous membrane by theprojectile. In such a case it is extremely difficult 258 ]yOl\\DS OF THE VESSELS to diagnose the wounded vessel in advance. It willbe remembered that the anterior tibial line startsfrom the ante-peroneal hollow and runs to the middleof the instep (fig. 68). Deeply situated as it is,especially in its upper half, the artery is sometimesvery difficult to expose. Incision should follow theline just quoted, beginning three fingers-breadthsbelow the level of the knee joint. The fascia isdivided, and the inter-muscular septum between thetibialis anticus on the inside and the extensor longus. ¥ 08.—Incision along the line of the anterior tibial. (Broca.) digitorum pedis on the outside is found. This inter-space is not easy to find ; it should be rememberedthat it is curvilinear in form, and that the directorshould be first passed backwards, then horizontally,and afterwards forwards. The artery is at the bottomof the inter-muscular septum close to the interosseousmembrane. Arterial and arterio-venous aneurisms of the legand foot possess little surgical interest. During thelast two years some twenty arterio-venous aneurismsof these regions have come under operation. In allcases extirpation has been attempted. Where com-plete extirpation was impossible, recourse has some- WOUNDS OF VESSELS OF LEG. ETC. 259 times been had to multiple ligature. In no case haseither method been followed by circulatory disturb-ances of the foot and toes. This concludes this short study of wounds of theindividual vessels. I hope that the young ambulancesurgeo
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
