. Manual of operative surgery. mputa-tion may be converted into one having unequal flaps. When the surgeon desires to amputate by the flap method he of coursewould never dream of making the flaps in the indirect method described above,but would trace them out directly and fashion them either by cutting firstthrough the skin and then through the musculature or by transfixion. Amputation by transfixion is performed as follows. Example, amputation of the lower third of the thigh: Bring the patient so as to rest with his buttocks on the lower edge of thetable. Have an assistant hold the limb well
. Manual of operative surgery. mputa-tion may be converted into one having unequal flaps. When the surgeon desires to amputate by the flap method he of coursewould never dream of making the flaps in the indirect method described above,but would trace them out directly and fashion them either by cutting firstthrough the skin and then through the musculature or by transfixion. Amputation by transfixion is performed as follows. Example, amputation of the lower third of the thigh: Bring the patient so as to rest with his buttocks on the lower edge of thetable. Have an assistant hold the limb well free from the table. Apply theelastic constrictor after elevating the limb to render it anaemic. Step I.—Retract the skin upwards. At the middle of one side of the thighopposite the point where the bone is to be divided, pass a long amputatingknife through the limb immediately in front of the femur and make its pointemerge through the skin at a place directly opposite the point of insertion II50 AMPUTATION OR DISARTICULATION. Fig. 1413.—Amputation by transfixion. {Burghard.)
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