The surgeon's handbook on the treatment of wounded in war : a prize essay . ticulation of the fifth toe with its metatarsal bone. 1. The flap-operation can be performed here in a manner similarto that, which has been described before in the disarticulation ofthe thumb (pag. 194). 2. The left hand forcibly separates the fifth toe from the fourth,whilst the right carries a narrow knife upwards between the two meta-tarsal bones from the skin of the web, till it encounters resistance. 3. The end of the cutaneous incision is prolonged upwards abouticm both on the dorsal and plantar surfaces. 4. By
The surgeon's handbook on the treatment of wounded in war : a prize essay . ticulation of the fifth toe with its metatarsal bone. 1. The flap-operation can be performed here in a manner similarto that, which has been described before in the disarticulation ofthe thumb (pag. 194). 2. The left hand forcibly separates the fifth toe from the fourth,whilst the right carries a narrow knife upwards between the two meta-tarsal bones from the skin of the web, till it encounters resistance. 3. The end of the cutaneous incision is prolonged upwards abouticm both on the dorsal and plantar surfaces. 4. By forcible abduction of the fifth metatarsal bone its base isseparated first from that of the fourth metatarsal bone, and then fromthe cuboid. 5. The knife is carried round the projecting tuberosity of thefifth metatarsal bone, and from here downwards along the outer sideof the bone. A tongue - shaped outer flap is thus formed, whoserounded point is made to terminate exactly opposite the first incision,which was made in the web between the fourth and fifth toes (fig. 366).. Disarticulation of the fifth toe with its metatarsal bone. Fig. 367. f. Disarticulation at the tarso-metatarsal joints (Lisfranc) (fig. 367). 1. The joint between the cuboid and the fifth metatarsal bone,which lies immediately behind the tuberosity of the latter bone, is sought for at the outer borderof the foot. At the innerborder of the foot the jointbetween the internal cunei-form and the first metatar-sal bone, which is 4cm infront of the tuberosity ofthe scaphoid, is also points are markedwith indian ink or by ascratch with the knife. 2. The foot is raised,and from one point to theother (from left to right)a large semilunar flap is cut upon the sole of the foot, the convexity of which passes over the heads of the metatarsal bones. 3. The foot is brought down, and forcibly extended. The knife is then carried across the dorsum with a slight convexity forwards from one end of the plantar flap to
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Keywords: ., book, bookcentury1800, booksubjectwoundsandinjuries, bookyear1884
