. Operative surgery. rophy of the softparts and the separation of the metacarpal bones at the seat of the oper-ation do much to lessen the cosmetic effect originally gained by the am-putation. If possible, the divided ends of the palmar transverse ligamentshould be sewed together, which will serve to lessen the tendency to thelatter element of deformity. Amputation of the Last Four Metacarpal Bones (Disarticulation).—Make a semilunar flap from the tissue of the palm by a curved incision,beginning at the web of the thumb and terminating at the ulnar border ofthe flfth metacarpal bone (Fig. 523)
. Operative surgery. rophy of the softparts and the separation of the metacarpal bones at the seat of the oper-ation do much to lessen the cosmetic effect originally gained by the am-putation. If possible, the divided ends of the palmar transverse ligamentshould be sewed together, which will serve to lessen the tendency to thelatter element of deformity. Amputation of the Last Four Metacarpal Bones (Disarticulation).—Make a semilunar flap from the tissue of the palm by a curved incision,beginning at the web of the thumb and terminating at the ulnar border ofthe flfth metacarpal bone (Fig. 523). This flap can be made by transfixion ifdesired (Fig. 524). The dorsal incision (Fig. 525) begins at the same pointof the web of the thumb, and is carried to the upper third of the metacarpalbone of the index finger, and from there transversely across until it meetsthe ulnar extremity of the first incision. The flaps are reflected up to thecarpo-metacarpal joints, the hand is strongly abducted, and the carpo-meta-. 476 OPERATIVE SURGERY. carpal joint opened from the ulnar side, using great caution not to injurethe articulation of the trapezium and the metacarpal Ijone of the the thumb this operation would be of little avail in securing a use-
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Keywords: ., bookauthorbryantjosephdjosephde, bookcentury1900, bookdecade1900
