. The principles and practice of modern surgery . ner side for the right leg,and vice versa) makes a circular incision through the skin, four inchesbelow the tuberosity of the tibia. The integuments are next to be dis-sected up for two inches, and turned back; and the muscles are to bedivided down to the bone by a second cireidar incision. Then a longslender double-edged knife, called a catline, is passed between die bonesto di^tide the interosseous ligament and muscles, and both bones are sawnthrous:h together, the flesh being protected by a retractor, which shouldhave three tads. The spine o
. The principles and practice of modern surgery . ner side for the right leg,and vice versa) makes a circular incision through the skin, four inchesbelow the tuberosity of the tibia. The integuments are next to be dis-sected up for two inches, and turned back; and the muscles are to bedivided down to the bone by a second cireidar incision. Then a longslender double-edged knife, called a catline, is passed between die bonesto di^tide the interosseous ligament and muscles, and both bones are sawnthrous:h together, the flesh being protected by a retractor, which shouldhave three tads. The spine of the tibia, if it projects much, may be re-moved with a fine saw or bone nippers, and care should be t-aken eot toleave the fibula longer than the tibia, or it wiU give much trouble. Theanterior and posterior tibial and peronaeal arteries, and any others requir-ing it, being tied, the stump is to be treated as directed afiier amputationof the thigh. The integuments should be pat together, so as to make aperpendicular line of junction. Fig. (2.) But it is agreed on all sides that the flap operation is by far thebest for this situation, and the easiest way of performing it is as follows:— The surgeon passes his knife horizontally behind both bones at thelevel of an inch below the head of the fibula, and cuts downwards andtrrwards, so as to make a flap of the posterior muscles about four or fiveinches long. A semilunar incision, with the convexity downwards, is AMPUTATION OF THE ARM. 539 then made across the front of the limb, the skin is slightly turned back,the parts between the bones are divided, and the bones are sawn as the manner in which Mr. Fergusson performs this amputation rendersit by far the most elegant and expeditious operation which the authorever witnessed. He first places the heel of the knife on the side of thelimb farthest from him, and draws it across the front of the limb, cuttinga semi-lunar flap of skin; when its point has arrived at the
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Keywords: ., bookcentury1800, booksubjectgeneralsurgery, booksubjectsurgery
