. Modern surgery, general and operative. xation by some form of apparatus should be maintained for atleast a year and probably nearly two years after excision (J, Torrance Rugh,Am. Jour. Orthopedic Surgery, Feb., 1909). Excision of the Ankle-joint.—Excision of the ankle was first performedby Moreau in 1792. This operation is performed chiefly for gunshot-wounds,compound dislocations, and in some cases of tuberculous joint disease. Ex-cision of the ankle is an operation which is seldom performed. Operation by Hancocks Method.—In this operation the patient lies uponhis back, the foot rests upon
. Modern surgery, general and operative. xation by some form of apparatus should be maintained for atleast a year and probably nearly two years after excision (J, Torrance Rugh,Am. Jour. Orthopedic Surgery, Feb., 1909). Excision of the Ankle-joint.—Excision of the ankle was first performedby Moreau in 1792. This operation is performed chiefly for gunshot-wounds,compound dislocations, and in some cases of tuberculous joint disease. Ex-cision of the ankle is an operation which is seldom performed. Operation by Hancocks Method.—In this operation the patient lies uponhis back, the foot rests upon its inner side, and the surgeon stands to the outerside of the damaged limb. Begin an incision just behind and 2 inches abovethe external malleolus, and carry it across the front of the joint to a correspond-ing point above and behind the internal malleolus (see Fig. 497, b); this in-cision goes through the skin only, and the flap thus marked out is down upon the external malleolus, carrying the knife close to the edge. Fig. 500.—Watsons plaster-of-Paris swing-splint. of the bone both behind and below the process, dislodge the peronei tendons,and divide the external lateral ligaments (Joseph Bell). Cut the fibula iinch above the malleolus by means of pliers; divide the tibiofibular ligament;turn the foot upon its outer side; dissect from their habitat back of the innermalleolus the tendon of the posterior tibial muscle and the tendons of the flexorsof the toes; carry the knife around the inner malleolus close to the bony edge; sepa-rate the internal lateral ligament, and dislocate the lower end of the tibia throughthe wound by turning the sole of the foot downward; saw off the lower end ofthe tibia and the articular process of the astragalus, sawing away from the tendoAchillis, and removing the fragments by bone-forceps. Cut away diseasedsynovial membrane, and curet all sinuses and tuberculous areas. Arrestbleeding, irrigate, and drain. Sew up the wound, ins
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