The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . the foot. The peroneal tendons having been severed, it is conve-nient, before going further, to remove the lower end of the fibula, whichmay be doneeither with cutting pliers or with a small saw. Polaillondivides the fibula with a chain-saw above the malleolus, leaving the latterattached to the bones of the foot, but there are some advantages in the ordinarymethod, as allowing more thorough examination of tne astragalus. In trau-matic cases, a partial excision, involving only the articulat
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . the foot. The peroneal tendons having been severed, it is conve-nient, before going further, to remove the lower end of the fibula, whichmay be doneeither with cutting pliers or with a small saw. Polaillondivides the fibula with a chain-saw above the malleolus, leaving the latterattached to the bones of the foot, but there are some advantages in the ordinarymethod, as allowing more thorough examination of tne astragalus. In trau-matic cases, a partial excision, involving only the articulating extremities ofthe tibia and fibula, will often be sufiieient, and in cases of disease, if theastragalus be but slightly affected, it will be enough to remove its upper sur- ^ Medical and Surgical History, etc., Third Surgical Volume, page 875. 526 EXCISIONS AND RESECTIONS. face with saw or cutting pliers, and then to apply tlie gouge and osteotriteto any softened or carious patclies that may be found remaining. But underother eircumstances the astragalus should be removed entire. The surgeon Excision of the ankle-joint. next turns the foot inward, and, having carefully cleared the lower end ofthe tibia with the probe-pointed knife, cuts away the inner malleolus withstrong forceps, and then removes as much of the tibia as may be thoughtdesirable with the chain-saw, or, which I think preferable, as rendering the operation easier, makes a second, shortFig. 747. incision on the inner side of the limb, and then divides the tibia with a nar-row-bladed saw, passed directly acrossfrom one side to the other. During the after-treatment of ankle-joint excision, the limb may be kept ina fracture-box, or, which I prefer, in abracketed wire splint such as is shownin Fig. 747. The foot must be keptwell supported, lest a condition of ac-quired talipes Cquinus result. Fig. 748illustrates the result in a case of partialexcision of the ankle for compound frac-ture and dislocation, done
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