The practice of surgery : embracing minor surgery and the application of dressings, etc., etc., etc. . as that of the thumb, the flaps beingfirst formed before disarticulating the metacarpal from the unci-forme bone. AMTUTATION AT THE RADIO-CARPAL ARTICULATION. This may be performed either by a circular or double-flap ope-ration. Lisfranc has introduced another mode, which consists in passinga catling or double-edged knife across the anterior face of the wrist,from a point just below one styloid process to the lower edge ofthe other, and shaving downwards the surface of the wrist bones,so as t
The practice of surgery : embracing minor surgery and the application of dressings, etc., etc., etc. . as that of the thumb, the flaps beingfirst formed before disarticulating the metacarpal from the unci-forme bone. AMTUTATION AT THE RADIO-CARPAL ARTICULATION. This may be performed either by a circular or double-flap ope-ration. Lisfranc has introduced another mode, which consists in passinga catling or double-edged knife across the anterior face of the wrist,from a point just below one styloid process to the lower edge ofthe other, and shaving downwards the surface of the wrist bones,so as to form an anterior flap ; a semicircular incision is then madeby puncture on the dorsum, and the flap thus formed dissected up ;the knife is next passed under the styloid process of the radius, andswept along the curved line of the joint, so as to complete the dis-articulation. Liston performs the double-flap operation by making an inci- 148 AMPUTATION AT RADIO-CARPAL ARTICULATION. sion of a semilunar form, with a small amputating knife, throughthe integument over the second range of carpal Tins flap is pulled back, and the joint opened ; the lateral liga-ments and tendons on the radial and ulnar sides are divided; asecond flap, a little longer and more full, is formed by bringingthe knife out in the palm. The arteries are secured, and the parts brought together withadhesive straps, and cold applied, if necessary, to keep down inflam-mation. In all the amputations of the fore-arm and arm, the brachialartery should be compressed, cither by the fingers of an assistantor a tourniquet. AMPUTATION OF THE FORE-ARM. 149 AMPUTATION OF THE FORE-ARM. The fore-arm may be amputated either by a circular, single-flapor double-flap operation. Circular Operation.—The amputating-knife is carried round thefore-arm, dividing the skin and subcutaneous cellular tissue, whichis dissected up one-half the diameter of the limb, and turned overlike the cuff of a coat; close to its fold the mus
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