The surgeon's handbook on the treatment of wounded in war : a prize essay . Palmar incision by transfixion. Palmar incision. Disarticulation of the last four metacarpal bones. 13; 2. An incision is made upon the back of the hand, which, be-ginning from the web of the thumb, is carried obliquely upwards tothe upper third of the second metacarpal bone. From there it is con-tinued transversely over the three last metacarpal bones, till it meetsthe palmar flap at the ulnar border of the hand (fig. 344). Fig. 344. Fig. Er %:., ^ Disarticulation of the last four metacarpalbones (dorsal incisio
The surgeon's handbook on the treatment of wounded in war : a prize essay . Palmar incision by transfixion. Palmar incision. Disarticulation of the last four metacarpal bones. 13; 2. An incision is made upon the back of the hand, which, be-ginning from the web of the thumb, is carried obliquely upwards tothe upper third of the second metacarpal bone. From there it is con-tinued transversely over the three last metacarpal bones, till it meetsthe palmar flap at the ulnar border of the hand (fig. 344). Fig. 344. Fig. Er %:., ^ Disarticulation of the last four metacarpalbones (dorsal incision). Stump after disarticulation of the last fourmetacarpal bones. 3. After both flaps have been reflected as far as the carpo-meta-carpal joints, the latter are opened from the ulnar side during a strongabduction of the hand, till the second metacarpal bone is disarticulatedfrom the trapezium. In this latter part of the operation great caremust be taken to cut always upon these two bones, so as to avoidinjuring the joint between the trapezium and the metacarpal bone ofthe thumb. 4. The preservation of the thumb is an immense advantage(fig. 345). w f. Disarticulation at the wrist. a. Circular incision. 1. A circular incision is carried round the hand over the middleof the metacarpal bones, 4om below the styloid processes. 2. The skin is liberated all round by perpendicular incisions, tillit can be reflected over the styloid processes like a cuff. 3. The hand is pronated and forcibly flexed: the tendons aredivided
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Keywords: ., book, bookcentury1800, booksubjectwoundsandinjuries, bookyear1884
