. Operative surgery. f thelimb promptly; retract these, then witha circular sweep of the long knife severthe remaining muscles parallel with theintegumentary incision, at the highestpoint practicable ; expose the bone, ad- Fig. 636.—a. Circular amputation, the retractor, and use the saw as Saw line. i. Antero-posterior method., . „, , • i- i! .1 o. Saw line. c. External racket meth- before. The angular projection ot the qJ^ disarticulation. linea aspera is removed with a rongeur or bone forceps. This amputation is best employed at the lower third ofthe thigh. However, when practiced at
. Operative surgery. f thelimb promptly; retract these, then witha circular sweep of the long knife severthe remaining muscles parallel with theintegumentary incision, at the highestpoint practicable ; expose the bone, ad- Fig. 636.—a. Circular amputation, the retractor, and use the saw as Saw line. i. Antero-posterior method., . „, , • i- i! .1 o. Saw line. c. External racket meth- before. The angular projection ot the qJ^ disarticulation. linea aspera is removed with a rongeur or bone forceps. This amputation is best employed at the lower third ofthe thigh. However, when practiced at either of the other thirds, the ob-liquity of the incision is lessened, it being the least oblique at the upper modification of this method is easier of performance than theoriginal, and consists in making two equal, short, antero-posterior flaps ofintegument by means of short, lateral incisions at either aspect of the thigh,carried upward from a circular incision of the integumentary tissues of the. 536 OPERATIVE SURGERY. limb. The flaps, and two inches additional of integument above them, aredissected up, and the exposed muscles are divided in front at the highest and behind at the lowest pointof exposure, down to the retractor is adjusted, andthe bone sawed about two inchesabove the line of division of theanterior muscles. The Amputation ty the Sin-gle Circular-incision Method(Celsus).—With a long knifedivide all the soft parts by acircular sweep down to thebone (Fig. 637), which is thensawed off. The end of the divided boneis now seized by strong forceps,and the surrounding soft partsare drawn upward, when, if de-sirable, a periosteal flap can bemade, its base corresponding tothe site of secondary section ofthe bone (Fig. 638). Saw thebone a second time close to theperiosteal flap, and allow theparts to fall into position. Theamount of bone to be removedat the second division is estimated the same as is the length of the flap inother amputations
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