Military medical and surgical essays ; prepared for the United States Sanitary Commission . ty of the os calcis, so as to avoid laceratingthe soft parts, which he, at the same time, gently butsteadily presses back until he exposes and divides thetendo-Achillis. The foot should be disarticulated be-fore the malleolar projections are removed, which itis always proper to do, and which may be most easily AMPUTATIONS. 475 effected by passing a knife around the exposed ex-tremities of the bones, and then sawing off a thinslice of the tibia connecting the two processes.* directs the articular
Military medical and surgical essays ; prepared for the United States Sanitary Commission . ty of the os calcis, so as to avoid laceratingthe soft parts, which he, at the same time, gently butsteadily presses back until he exposes and divides thetendo-Achillis. The foot should be disarticulated be-fore the malleolar projections are removed, which itis always proper to do, and which may be most easily AMPUTATIONS. 475 effected by passing a knife around the exposed ex-tremities of the bones, and then sawing off a thinslice of the tibia connecting the two processes.* directs the articular surface of the tibia alwaysto be removed. This certainly should be done, if thedisease has attacked the part; but if healthy it seemsto be unnecessary. In one of the writers cases theextremity of the tibia was removed, but without anyapparent benefit as respects the result. The follow-ing wood-cuts, of reduced size, taken from similarillustrations in the Monthly Journal, Feb. 1850, givea more correct idea of the line of incision than canany verbal description. It will be seen that they. differ very materially from those given in principal precaution to be observed, is in the dis-section on the posterior part of the os calcis, in ordernot to wound, the posterior tibial artery, and thusdeprive the flap of its nourishment. It is recom-mended by some surgeons to disarticulate before dis-secting the posterior flap. This proceeding increases * Synies Contributions to Surgery. 476 AMPUTATIONS. the liability to wound this vessel, nor does it facili-tate the operation. The artery may readily beavoided by keeping the edge of the knife constantly
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Keywords: ., bookcentury1800, bookdecade1860, booksubjectmedicine, bookyear186
