. Minor and operative surgery, including bandaging . emur and remove it; Jordan and Senn dis-articulate the head of the bone first through an externalincision, and control the bleeding before the amputation iscompleted by passing an elastic tourniquet around the softparts above the point where they are to be divided. The methods of amputation at the hip-joint are theoval, antero-posterior flap and lateral flap, and modifiedcircular methods. Transfixion Method.—In this method the point of along amputating-knife is thrust into the tissues about twofinger-breadths below the anterior superior spin
. Minor and operative surgery, including bandaging . emur and remove it; Jordan and Senn dis-articulate the head of the bone first through an externalincision, and control the bleeding before the amputation iscompleted by passing an elastic tourniquet around the softparts above the point where they are to be divided. The methods of amputation at the hip-joint are theoval, antero-posterior flap and lateral flap, and modifiedcircular methods. Transfixion Method.—In this method the point of along amputating-knife is thrust into the tissues about twofinger-breadths below the anterior superior spinous process AMPUTATIONS AT THE HIP-JOINT. 531 of the ilium, and is pushed through the tissues, grazingthe hip-joint, and brought out on the opposite side of thethigh close to the junction of the scrotum. The knife isnext carried downward close to the bone, and an anteriorflap of sufficient length is cut from within outward. Thisflap is held up by an assistant and the head of the bonedisarticulated, and, the knife being passed behind the Fig. Amputation at the hip-joint by antero-posterior (Holmes.) bone, a posterior flap of equal length is cut from withinoutward (Fig. 435). Guthries method of amputation at the hip-joint consistsin cutting the flaps from without inward, a smaller knifebeing used for this purpose and the posterior flap beingcut first. Modified Circular Method.—In this operation shortantero-posterior flaps of skin and connective tissue arecut and dissected up, the muscles are divided by a circular 532 AMPUTATIONS. incision at the level of the joint, and disarticulation of thehead of the femur is next effected. Lateral Flap Method.—In this operation two flaps arecut from the inner and outer side of the thigh by trans-fixing, or by cutting from without inward and exposingthe joint, which is opened and disarticulation of the head Fig. 436.
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