The surgeon's handbook on the treatment of wounded in war : a prize essay . tarsus, the posterior flap must bethe larger. 4. The oval incision is especially suitable for small joints, as thoseof the fingers and toes. 5. After the division of the soft parts, the joint is opened; thebands of tissue, as they present themselves, being put upon the stretchby suitable movements, and then divided with the knife. 6. After the division of the remaining ligaments and the capsuleof the joint, the disarticulation is completed; and finally the articularsurface is removed with the saw. For the rest of the o
The surgeon's handbook on the treatment of wounded in war : a prize essay . tarsus, the posterior flap must bethe larger. 4. The oval incision is especially suitable for small joints, as thoseof the fingers and toes. 5. After the division of the soft parts, the joint is opened; thebands of tissue, as they present themselves, being put upon the stretchby suitable movements, and then divided with the knife. 6. After the division of the remaining ligaments and the capsuleof the joint, the disarticulation is completed; and finally the articularsurface is removed with the saw. For the rest of the operation theproceeding is the same as in an amputation. III. THE AMPUTATIONS AND DISARTICULATIONS OF THE UPPER EXTREMITY. a. Disarticulation of the terminal phalanx. (By a palmar flap from without inwards.) 1. The hand being held towards him in the prone position, theoperator seizes the tip of the finger, and flexes the terminal phalanx. 2. A semilunar incision, 2 mm below the top of the joint and carriedacross the head of the second phalanx, opens the joint (fig. 328).. 3. The point of the knife divides the lateral ligaments, while theblade with the edge directed downwards, is sunk behind the flexor aspectof the third phalanx (fig. 329), and cuts with a, sawing movement awell rounded flap from the tissues on the flexor side (fig. 330). Fig. 329. Fig. 330.
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Keywords: ., book, bookcentury1800, booksubjectwoundsandinjuries, bookyear1884
