A manual of operative surgery . re commenced about one inchbelow the point at which the bones aredivided. The inner limb of the U of theposterior flap is just behind the internalborder of the tibia, while the outer limb ofthe U runs posterior to the peronei muscles(Fig. 412, b). These muscles are conse-quently found divided in the anterior flap. (1) The operation is commenced bycutting the large flap. On the right side the limb is turnedupon its outer surface ( with that sur-face looking downwards), the knee is flexed,and the inner vertical incision is made fromabove downwards. The inner s
A manual of operative surgery . re commenced about one inchbelow the point at which the bones aredivided. The inner limb of the U of theposterior flap is just behind the internalborder of the tibia, while the outer limb ofthe U runs posterior to the peronei muscles(Fig. 412, b). These muscles are conse-quently found divided in the anterior flap. (1) The operation is commenced bycutting the large flap. On the right side the limb is turnedupon its outer surface ( with that sur-face looking downwards), the knee is flexed,and the inner vertical incision is made fromabove downwards. The inner segment ofthe bend of the U is then completed. Theleg is now turned upon its inner side, andthe outer vertical incision is made by cut-ting from above downwards. On finishingit, the bend of the U, the terminal part of the flap, is completed (Fig. 412, b). On the left leg the limb maybe first turned upon its inner side ( with that surface lookingdownwards), and the operation be commenced by cutting the outervertical fig. 412.—A, Modified circularsupramalleolar amputation :a, Saw-line of same ; B,Heys amputation : b, Saw-line of same ; c, Circularamputation at the place ofelection c, Saw-line ofsame ; d, Grittis operation. 618 AMPUTATIONS [part vi The incisions thus made concern the skin only, and the integu-ments are well freed along all parts of the cut. (2) The leg is now flexed upon the thigh, and the knee turnedoutwards so as to expose the calf. When in this position, and whilethe foot is flexed, the gastrocnemius muscle is picked up between thefingers and thumb and is divided transversely at the level of the re-tracted skin. (3) Two short, deep, vertical incisions are now made from abovedownwards through the soft parts at either margin of the flap. These
Size: 891px × 2804px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
