. Manual of operative surgery. One of the great disadvantages ofsuch amputations as Choparts is that the heel liable to be pulled up by the Gastrocnemiusthus giving a poor stump. Corlette seems to have reason in claiming thatthe pushing forward of the Calcaneus (Step 9) overcomes this fault byshortening the heel levers. The careful suturing of the dorsal tendons to theplantar tissues (advised by Selegarde in Choparts operation) aids in securinga good stump. Corlettes Amputation No. 2.âStep i.âReflect flaps as in Corlettes Ampu-tation No. I, but make them shorter. Step 2.âRemove the foot
. Manual of operative surgery. One of the great disadvantages ofsuch amputations as Choparts is that the heel liable to be pulled up by the Gastrocnemiusthus giving a poor stump. Corlette seems to have reason in claiming thatthe pushing forward of the Calcaneus (Step 9) overcomes this fault byshortening the heel levers. The careful suturing of the dorsal tendons to theplantar tissues (advised by Selegarde in Choparts operation) aids in securinga good stump. Corlettes Amputation No. 2.âStep i.âReflect flaps as in Corlettes Ampu-tation No. I, but make them shorter. Step 2.âRemove the foot by medio-tarsal disarticulation. Remove thesustentaculum tali. Excise the talus. Step 3.âSeparate the soft parts from the sides and upper surface of thecalcaneus. Posteriorly this separation need not extend far down the sides ofthe bone. In making these separations always hug the bone with the rugineor knife lest vessels be injured. Remove the prominent upper and anteriorpart of the greater process of the 1451.âCorlettes amputation. II76 AMPUTATION OR DISARTICULATION Step 4.âAfter groo\ ing ihe bone slice away the upper jjart of the calcaneus(Fig. 1451 c-d) leaving a plane of raw surface sloping upwards and must be done in such fashion that the normal bearing surface of the soleof the heel will be capable of pressing on the ground directly under (in the bear-ing line of) the tibia after the calcaneus is pushed forward. It is wise to removethe upper part of the calcaneus not en masse, but by shaving but by bit. Notethat the upper surface of the calcaneus is removed to its posterior extremity,but the line of section does not involve the insertion of the tendo Achillis. Step 5.âWith osteotome remove the articular surface of the tibia betweenthe malleoli, but do not injure the compact layer of bone on the articular sur-faces of both malleoli; this is important as the malleoli are retained principallyto give lateral support and for purposes of wari
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