Operative surgery, for students and practitioners . vides the ligamentum patellae. The knee-joint having been thus opened, the limb is stronglyflexed at the hip and Iniee, with the sole of the foot resting upon thetable, and it is thus supported by an assistant. The lateral ligamentsand the lateral portions of the capsule are now divided, cutting themclose to the surface of the femur. The knee being still more markedly flexed, the crucial ligamentsare divided close to their attachment to the upper surface of the tibia,cutting with the edge of the knife directed downward, as if one wouldcut int
Operative surgery, for students and practitioners . vides the ligamentum patellae. The knee-joint having been thus opened, the limb is stronglyflexed at the hip and Iniee, with the sole of the foot resting upon thetable, and it is thus supported by an assistant. The lateral ligamentsand the lateral portions of the capsule are now divided, cutting themclose to the surface of the femur. The knee being still more markedly flexed, the crucial ligamentsare divided close to their attachment to the upper surface of the tibia,cutting with the edge of the knife directed downward, as if one wouldcut into the articular surface of the upper end of the tibia; if theligaments are divided with the edge of the Imife directed backward,one may accidentally cut the popliteal vessels. AMPUTATIONS, EESECTIONS, ETC. 813 The anterior flap, wliicli includes the patella, should be dis-sected back and retracted sufficiently to allow free access into thesMiovial pouch, which is located above the patella, between the quad-riceps tendon and the front of the Fig. 358.—Right Leg, Inner Side. AS, incision upon tlie inner aspect ofthe ankle for resection of the astragalus; K, Textor incision for resection ofthe knee-joint. Dotted lines indicate planes of section through the bones. With mouse-tooth forceps and blunt-pointed scissors, curvedon the flat, the synovial membrane which lines the joint may now beentirely resected. If the bones are healthy, one may stop at this 814 LOWER EXTREMITY. stage of the operation and close the wound, after irrigating thor-oughly and 231oviding for suitable drainage (arthrectomy). In resecting that jDart of the synovial membrane which linesthe posterior part of the capsule one should avoid cutting deeply,on account of the liability to injure the popliteal vessels, which lieadjacent to this part of the capsule. There is rather less dangerof doing this if the posterior ligament is put upon the stretch bydrawing the tibia away from the femur while this part of
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
