Modern surgery, general and operative . or and short posterior flap. In Kochers obliqueoperation the incision begins anteriorly over the joint-line and ends posteriorlya hands breadth below the summit of the olecranon (Fig. 965). A posteriorflap which contains the integument, the insertion of the triceps, the anconeus,and the periosteum is dissected up until the posterior surface of the humerusis reached. The joint is opened anteriorly by a transverse incision, and theradiohumeral articulation is opened from without inward (Kocher). In thedouble flap operation the forearm is partly flexed and
Modern surgery, general and operative . or and short posterior flap. In Kochers obliqueoperation the incision begins anteriorly over the joint-line and ends posteriorlya hands breadth below the summit of the olecranon (Fig. 965). A posteriorflap which contains the integument, the insertion of the triceps, the anconeus,and the periosteum is dissected up until the posterior surface of the humerusis reached. The joint is opened anteriorly by a transverse incision, and theradiohumeral articulation is opened from without inward (Kocher). In thedouble flap operation the forearm is partly flexed and a skin-cut marksout a long anterior flap, the knife being entered opposite the external condyleand being withdrawn i inch below the internal condyle. The muscles, whichare bunched forward, are cut by transfixion. A posterior semilunar flap ismade, which separates the attachments of the radius, the ulna is cleared, andthe triceps is cut at its insertion (Bell). Gross advocated sawing throughthe olecranon and the inner trochlear Tig. 966.—Use of Wyeths pins in amputation at the shoulder-joint. The acromion is marked by a black line (Keen). Amputation of the arm is best performed by marking out with a knifetwo equal semilunar anteroposterior flaps, the first cut being carried throughthe skin alone, the muscles being then transfixed with a long knife. Tealesmethod is shown in Figs. 438 and 439. The circular or the modified circu-lar amputation may be performed. Disarticulation at the Shoulder=joint.—In this operation somesurgeons use Wyeths pins to hold the Esmarch band in place. The an-terior pin is entered at the middle of the lower margin of the anterior axillaryfold, and emerges i inch within the tip of the acromion. The posterior pinis entered at a corresponding point on the posterior axillary fold, and emergesmore posteriorly than the first pin and an inch within the tip of the the extremity has been drained of blood by the Esmarch bandage or byst
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
