A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . (Dennis.) for no mechanical device is equal to even a defective finger. If a por-tion of the thumb and a part of another finger can be saved to oppose DISARTICULATIONS OF THE HAND. 799 it, the patient is given a member which can grasp objects. The mus-cles soon become accustomed to their new functions and give service-able results, even in very distorted hands. It is, however, justifiableto remove a stiff finger, which obstructs
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . (Dennis.) for no mechanical device is equal to even a defective finger. If a por-tion of the thumb and a part of another finger can be saved to oppose DISARTICULATIONS OF THE HAND. 799 it, the patient is given a member which can grasp objects. The mus-cles soon become accustomed to their new functions and give service-able results, even in very distorted hands. It is, however, justifiableto remove a stiff finger, which obstructs the movements of the amputate the head of a metacarpal bone, which has lost thephalanges attached to it, may lessen the noticeable deformity by al-lowing the adjacent fingers to fall together and close the gap. If,however, most of the hand is destroyed by injury, a small part of afinger or of a metacarpal bone saved may be very useful. Sometimesthe skin of a badly damaged finger may be preserved to cover anotherfinger. Amputation through the middle of the metacarpal bonesleaves quite a useful member. Antero-posterior flaps are satisfactory. Fig. Amputation of first and second phalanges of the thumb, and excision of the metacarpal bone of indexfinger ; transplantation of metacarpal bone of the thumb to the index finger. (Dexnis.) Disarticulation at the phalangeal joints is well performed by a shortdorsal and a long palmar flap or by the oblique circular method so ar-ranged as to make a palmar flap. The metacarpophalangeal disarticu-lations are often accomplished by racket incisions, though any of theother methods may be used. The head of the metacarpal bone maybe removed or allowed to remain. In disarticulating the phalangeal orthe metacarpophalangeal joints it must be recollected that the joint isentered by drawing the edge of the knife transversely across the fingerjust below the head of the bone above, when the joint is flexed. Inoperating for injury formal a
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