. Minor and operative surgery, including bandaging . ticulation of little Disarticulation of fifth metacarpal bone. G. Amputation at the wrist,circular. H. Amputation at the wrist, lateral. (Stimson.) Amputations of the Metacarpal Bones.—In ampu-tating the metacarpal bones it is advisable to leave thecarpal ends of the bones to avoid opening the wrist-joint,except in the case of the first and fifth metacarpal bones,which do not communicate with the others and with thesynovial sacs. The incisions for the removal of the metacarpal bones 32 498 AMPUTATIONS. are the same as for the remov
. Minor and operative surgery, including bandaging . ticulation of little Disarticulation of fifth metacarpal bone. G. Amputation at the wrist,circular. H. Amputation at the wrist, lateral. (Stimson.) Amputations of the Metacarpal Bones.—In ampu-tating the metacarpal bones it is advisable to leave thecarpal ends of the bones to avoid opening the wrist-joint,except in the case of the first and fifth metacarpal bones,which do not communicate with the others and with thesynovial sacs. The incisions for the removal of the metacarpal bones 32 498 AMPUTATIONS. are the same as for the removal of a finger at the meta-carpophalangeal joint, the incision being prolonged back-ward as far as necessary over the dorsal surface of thebone (Fig. 396, _D.) After the metacarpal bone has beenbared for a sufficient distance, it is cut through with bone-pliers or disarticulated, and the distal end is raised fromits bed and carefully separated from the soft parts, carebeing taken to avoid injury of the structures of the palmof the hand. Fig. Removal of the head of a metacarpal bone. (Skey.) In amputating the fifth metacarpal bone, the incisionshould be made along the inner border of the hand andcarried down to the bone between the skin and the ab-ductor minimi digiti muscle (Fig. 398). The lower endof the incision passes over the knuckle to the web of thefinger, and backward under the palmar surface to join thefirst incision. Amputation of the entire thumb with its metacarpalbone is effected by making an oval flap from the palmar AMPUTATIONS AT THE WRIST. 499 surface; in the case of the left thumb, the joint may beopened by an oblique incision on the dorsal surface of thehand, beginning a little in front of the joint and beingcarried down to the web between the thumb and fore-finger; the palmar flap is then made by thrusting the knifeupward to its point of entrance and cutting downwardand outward. In amputating the right thumb with itsmetacarpal bone, it is better to ma
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