. The principles and practice of surgery. of its capsule. Then elevating the handlein the direction forwards, as much as the skin and fascia lata will per-mit, and at the same time inclining the handle toward the head of thepatient, the point, under steady pressure, will continue to descend underthe ilio-femoral ligament, and the conjoined tendon of the psoas mag-nus and iliacus interims, and finally emerge well back and below thetuberosity of the ischium. With a sawing motion the surgeon enlarges the incision downwardsalong the front of the trochanter major and neck, until sufficient spaceis
. The principles and practice of surgery. of its capsule. Then elevating the handlein the direction forwards, as much as the skin and fascia lata will per-mit, and at the same time inclining the handle toward the head of thepatient, the point, under steady pressure, will continue to descend underthe ilio-femoral ligament, and the conjoined tendon of the psoas mag-nus and iliacus interims, and finally emerge well back and below thetuberosity of the ischium. With a sawing motion the surgeon enlarges the incision downwardsalong the front of the trochanter major and neck, until sufficient spaceis made to allow a second assistant to introduce the four fingers of eachhand into the anterior and posterior wounds, and to seize the femoralvessels between his thumbs and fingers. The first assistant, pressingupon the vessels over the brim of the pelvis, must not withdraw hispressure until the second assistant has satisfied himself that he hasthem in his grasp. The surgeon then rapidly completes the section of the anterior flap, Fig. Compression of the Femoral Artery in the Flap. raising the edge of his knife a little to overcome the elevation of thetrochanter minor, and carrying it down close to the shaft of the femur 378 AMPUTATION AT THE HIP-JOINT. far enough to make a flap of from five to seven inches in length—moreor less, according to the diameter of the limb—and finally bringing theedge of the knife to the surface obliquely. Second.—An assistant, grasping the knee and leg, rotates the thighoutwards, while he forcibly abducts and carries it backwards over thecorner of the table and toward the floor. If, in the first step of the operation, the point of the knife has struckskilfully the capsule covering the head of the bone, the disarticulationmay be accomplished by the manoeuvre just described. In other casesit will be necessary for the surgeon to apply the knife to the capsule,and for this purpose a large scalpel is the most convenient—dividingthe capsule fir
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectg, booksubjectsurgery
