A manual of operative surgery . the abductor pollicis. Inasmuch as this is the chief vesselof the flap, the greatest care must be taken of it. (See page 594.)Minute branches may reach the flap from the internal malleolarof the posterior tibial and from the outerand inner malleolar of the anterior tibial. The lower epiphysis of the tibia in-cludes the articular surface and the innermalleolus. It joins the shaft between theeighteenth and nineteenth years. Thelower epiphysis of the fibula corresponds tothe outer malleolus, and joins the shaftabout the twenty-first year. The os calcishas an epiphy
A manual of operative surgery . the abductor pollicis. Inasmuch as this is the chief vesselof the flap, the greatest care must be taken of it. (See page 594.)Minute branches may reach the flap from the internal malleolarof the posterior tibial and from the outerand inner malleolar of the anterior tibial. The lower epiphysis of the tibia in-cludes the articular surface and the innermalleolus. It joins the shaft between theeighteenth and nineteenth years. Thelower epiphysis of the fibula corresponds tothe outer malleolus, and joins the shaftabout the twenty-first year. The os calcishas an epiphysis for its posterior forms a cartilaginous shell for that partof the bone. It only commences to ossifyin the tenth year, and joins the body of thebone at fifteen or sixteen. In removing the lower ends of thetibia and fibula the greater part of the an-terior and posterior tibio-fibular ligaments,together with the interosseous ligament, aresaved, while the transverse or inferior liga-ment is cut away with the -PLANTAR INCISIONS. FIG. 399 A, Lisfrancs; B, Choparts;c, Pirogofts; D, Symes;E, Farabeufs subastragaloidamputation ; f, Farabeufsamputation at the ankle. Instruments—A stout narrow knife,with a blade three inches long, a narrowbut rounded point, and a large stronghandle ; a scalpel ; a saw ; two metal retractors to hold backthe flaps when sawing the leg bones ; lion forceps ; pressureforceps ; artery and dissecting forceps, scissors, etc. Position.—The patient lies on the back, with the foot pro-jecting beyond the end of the table and the toes pointing up-wards. The surgeon sits facing the end of the table. The lowerend of the leg is raised on a Volkmanns pelvic support to thelevel of the surgeons face. The surgeon sits to cut the heelflap, and stands to cut the dorsal flap and to assistants stand facing the surgeon, one on each side of the chap, viii] AMPUTATIONS OF THE FOOT 593 end of the table. One steadies the foot, the other
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