A manual of operative surgery . the fifth meta-carpal bone at its palmar aspect. Thedorsal lip of the incision is thenraised, and the tendon of the extensorcarpi ulnaris cut at its insertion, andits tendon dissected up from its groove in the ulna, care being taken notto isolate it from the integuments, which would endanger its finger extensors are then separated from the carpus, and thedorsal and internal lateral ligaments of the wrist joint divided, butthe connections of the tendons with the radius are purposely leftundisturbed. Attention is now directed to the palmar side of the
A manual of operative surgery . the fifth meta-carpal bone at its palmar aspect. Thedorsal lip of the incision is thenraised, and the tendon of the extensorcarpi ulnaris cut at its insertion, andits tendon dissected up from its groove in the ulna, care being taken notto isolate it from the integuments, which would endanger its finger extensors are then separated from the carpus, and thedorsal and internal lateral ligaments of the wrist joint divided, butthe connections of the tendons with the radius are purposely leftundisturbed. Attention is now directed to the palmar side of the anterior surface of the ulna is cleared by cutting towards thebone so as to avoid the artery and nerve, the articulation of the pisiformbone opened, if that has not been already done in making the incision,and the flexor tendons separated from the carpus, the hand beingdepressed to relax them. While this is being done, the knife is arrestedby the unciform process, which is clipped through at its base with FIG. 459.—EXCISION OF THE WRIST.(LISTERS INCISION.) 734 OPERATIONS ON BONES AND JOINTS [part vii Care is taken to avoid carrying the knife farther down the handthan the bases of the metacarpal bones, for this, besides inflictingunnecessary injury, would involve risk of cutting the deep palmararch. The anterior ligament of the wrist-joint is also divided, afterwhich the junction between the carpus and metacarpus is severedwith cutting pliers, and the carpus extracted from the ulnar incisionwith sequestrum forceps, and by touching with the knife any liga-mentous connections. The hand being now forcibly everted, the articular ends of theradius and ulna will protrude at the ulnar incision. If they appearsound, or very superficially affected, the articular surfaces only areremoved. The ulna is divided obliquely with a small saw, so as totake away the cartilage-covered rounded part over which the radiussweeps, while the base of the styloid process is retaine
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Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
