. The principles and practice of modern surgery. ssarily be wounded. They should be at-tempted, however, in case of wounds—but for aneurisms of these arteries,it is necessary to tie the internal or common iliac. XVI. The Popliteal artery may be tied by cutting through the skinand fascia lata for the extent of three inches on the outer border of thetendon of the semi-membranosus muscle—the patient being placed onhis face, with his knee straight. On pressing that tendon inwards, theartery may be felt. Its vein, which lies superficial and rather externalto it, must be cautiously separated and dra
. The principles and practice of modern surgery. ssarily be wounded. They should be at-tempted, however, in case of wounds—but for aneurisms of these arteries,it is necessary to tie the internal or common iliac. XVI. The Popliteal artery may be tied by cutting through the skinand fascia lata for the extent of three inches on the outer border of thetendon of the semi-membranosus muscle—the patient being placed onhis face, with his knee straight. On pressing that tendon inwards, theartery may be felt. Its vein, which lies superficial and rather externalto it, must be cautiously separated and drawn outwards, and the needlebe passed between them. This operation is very seldom performed. XVII. Posterior Tibial Artery.—The operation usually recom-mended for tying this artery in the upper part of the leg is performedthus: The limb being placed on its outer side, with the knee bent andthe foot extended, an incision four inches in length must be made throughthe skin and fascia over the inner margin of the. tibia, avoiding the Fig. saphena vein. The edge of the gastrocnemius thus exposed is to beturned back. A director must then be insinuated beneath the inner headof the solseus, and this muscle must be divided from its attachment to thetibia. The strong and tense fascia beneath it must next be divided inthe same manner. Then, the muscles being relaxed as much as possibleby bending the knee and extending the foot, the artery may be felt aboutan inch from the edge of the tibia. The veins are to be separated fromit, and an aneurism needle passed round it from without, inwards, so asto avoid the nerve. This operation, however, is considered by Mr. Guthrie to be so pain-ful, difficult, bloody, tedious, and dangerous, that he proposes to reach ANTERIOR TIBIAL ARTERY. 521 Fig. 153. the artery by making a perpendicular incision six or seven inches inlength, at the back of the leg, through the skin, gastrocnemius, plantaris,and solasus—then the fascia will be exposed wi
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