A manual of operative surgery . scribedcorresponds to the French incision en croupiere, and does not exactlyaccord with either the orthodox racket incision or the unmodifiedoval operation. The dorsal incision is commenced just above the head of themetacarpal bone ( opposite toits neck), and is carried down inthe median fine of the finger untilit has passed the base of thephalanx. The cut now divides, and itslimbs sweep obliquely acrosseach side of the root of thefinger. They are joined on thepalmar aspect by a transverseincision, which exactly followsthe crease between the fingerand the pa
A manual of operative surgery . scribedcorresponds to the French incision en croupiere, and does not exactlyaccord with either the orthodox racket incision or the unmodifiedoval operation. The dorsal incision is commenced just above the head of themetacarpal bone ( opposite toits neck), and is carried down inthe median fine of the finger untilit has passed the base of thephalanx. The cut now divides, and itslimbs sweep obliquely acrosseach side of the root of thefinger. They are joined on thepalmar aspect by a transverseincision, which exactly followsthe crease between the fingerand the palm, and is thereforelevel with the free margin of theweb (Fig. 363, f). The surgeon, having madeout the position of the joint,holds the finger in the proneposition in his left hand. Anassistant steadies the hand andkeeps the other fingers out ofthe way. Throughout the whole opera-tion the limb is kept in theprone position. The knife isentered upon the dorsum, and iscarried first across one side ofthe root of the finger and then. fig. 363.—A, Disarticulation by single exter-nal flap ; B, Amputation by lateral flaps ; C, Disarticulation by oval or racket incision ;. D, Modified racket incision for index finger ; E, Circular method, with vertical dorsal cut; F, Incision en croupiere ; G, Interno-palmarflap method for little finger ; h, Disarticula-tion by single palmar flap ; I, Disarticula-tion by racket incision ; K, Amputation offingers with their metacarpal bones; L,Circular disarticulation at the wrist. across the other side. The in-cision is completed by the transverse palmar cut. Three separatecuts with the knife are therefore required. There is no object in attempting to make the entire incision withone sweep of the scalpel. The incision should at first involve the skinonly. The finger is now extended to its utmost, and the palmar incisionis carried to the bone, the flexor tendons being thus stretched^anddivided. The finger being then turned to one or other side, the lat
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