. New York medical gazette and journal of health. tsoperation was performed than with the other. This can be accountedfor by the shortness of the lever left to the foot after the medio-tarsaloperation. By the removal of the os cuboides, which forms a projec-tion upon the sole of the foot externally, and of the os scaphoides andos cuneiforme internum, which form another projection internally, thefoot also loses its natural concavity upon the plantar aspect. The inconveniences resulting from Choparts operation may besuch, at times, as actually to require the removal of the lowerportion of the le
. New York medical gazette and journal of health. tsoperation was performed than with the other. This can be accountedfor by the shortness of the lever left to the foot after the medio-tarsaloperation. By the removal of the os cuboides, which forms a projec-tion upon the sole of the foot externally, and of the os scaphoides andos cuneiforme internum, which form another projection internally, thefoot also loses its natural concavity upon the plantar aspect. The inconveniences resulting from Choparts operation may besuch, at times, as actually to require the removal of the lowerportion of the leg. The following drawing exhibits a stump resultingfrom the operation by Choparts method. In this case the patientwas urgent for the amputation of the limb. The heel had becomeelevated so that the end of the stump, in walking, was partly pre-sented to the ground, ulceration had occurred on the line of thecicatrix, and progression became almost impossible without the useof crutches. Under these circumstances, I amputated the leg at itslower BriuU of Chopart* operation—Jeft foot 190 THE NEW -YORK In Ileys operation, as modified by Lisfranc, the entire tarsns ispreserved ; also the internal border of the foot remains longer by oneinch and a half, and the external border, by half an inch, than when theoperation by Choparts method is resorted to. There is a larger basefor the limb to rest upon during progression, and more firmness andassurance to the step are attained. The following drawing representsthe stump resulting from Ileys operation as performed by me withLisfrancs modification.
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