. Modern surgery, general and operative. an opening in the interosseous membrane, andruns down to the middle of the front of the ankle-joint. In the upper two-thirds of its course it rests upon the interosseous membrane, to which it isfastened by firm fascia; in the lower third it Hes first upon the front of the tibiaand then upon the anterior ligament of the ankle-joint. For its upper two-thirds the artery has the tibialis anticus muscle just external to it; at the junc-tion of the middle and lower thirds the extensor proprius pollicis comes fromthe outside and lies either upon the artery or
. Modern surgery, general and operative. an opening in the interosseous membrane, andruns down to the middle of the front of the ankle-joint. In the upper two-thirds of its course it rests upon the interosseous membrane, to which it isfastened by firm fascia; in the lower third it Hes first upon the front of the tibiaand then upon the anterior ligament of the ankle-joint. For its upper two-thirds the artery has the tibialis anticus muscle just external to it; at the junc-tion of the middle and lower thirds the extensor proprius pollicis comes fromthe outside and lies either upon the artery or to its inner side for the rest of itscourse. Externally in its upper third is the extensor communis digitorum;in the middle third is the extensor proprius pollicis; in the lower third, theproprius pollicis having crossed to the inner side, the extensor communis digi-torum again becomes the outer boundary. The artery is covered by skinand by superficial and deep fascia. In its upper third it is deeply placed between LIGATIONS. Plate 6,.. Posterior Tibial Artery 555 the muscles; in its middle third it is less overlaid by muscle; in its lower thirdit is superficial except where it is crossed by the extensor proprius and where itis covered by the annular ligament. The artery has venae comites. In thelower three-fourths of its course it is accompanied by the anterior tibial nerve,which in its course in the upper third of the leg is external to the artery; in themiddle third it is external and a little in front of the artery; and in the lowerthird it is external to or upon the artery (PI. 5, Fig. 5). Operations.—The ligations of the anterior tibial (PL 5, Fig. 6) are: (i) ofthe lower third; (2) of the middle third; (3) of the upper third. In all theseligations the patient is placed recumbent with the leg extended, and the surgeonstands to the outer side of the extremity, cutting from above downward onthe right side and from below upward on the left side. Ligation of the Lower Third
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Keywords: ., bookcentury1900, bookdecade1910, bookidmodernsurger, bookyear1919
