A manual of operative surgery . ryconsiderably from the procedures associated withhis name by more than one writer. (c) Esmarchs.—Mr. Barker ( Manual of Sur-gical Operations, 1887) gives the following ac-count of Esmarchs operation, in favour of whichhe speaks :— By a single, strong, muscular sweep of theknife five inches below the tip of the trochanter,all the soft parts of the thigh are divided com-pletely to the bone, and the latter is at once sawnacross. The vessels are then ligatured. The bone is now seized in a lion forcepsand steadied, while a second incision is made,commencing two inch
A manual of operative surgery . ryconsiderably from the procedures associated withhis name by more than one writer. (c) Esmarchs.—Mr. Barker ( Manual of Sur-gical Operations, 1887) gives the following ac-count of Esmarchs operation, in favour of whichhe speaks :— By a single, strong, muscular sweep of theknife five inches below the tip of the trochanter,all the soft parts of the thigh are divided com-pletely to the bone, and the latter is at once sawnacross. The vessels are then ligatured. The bone is now seized in a lion forcepsand steadied, while a second incision is made,commencing two inches above the tip of thetrochanter, and carried down along the latter, toterminate in the first circular cut. The twoborders of this incision being held apart by an assistant, the boneis cleared of the soft parts by the use of an elevator inserted underthe periosteum, and by the knife where the muscle-insertions aretoo firm for the latter. When the capsule is reached it is divided,and the head is dislocated in the usual FIG. 424.—FURNEAUXJORDANS AMPUTA-TION AT THE HIP-JOINT (SurgicalEnquiries, PlateX., page 288). Theshaded part repre-sents the areatraversed by theknife; the dottedlines the incision. 2. Disarticulation throug-h an Anterior Racket Incision.— This method is also known as the anterior oval method. It is founded upon the operations performed by Larrey in1793, by Sir Astley Cooper in 1824, by Roser in 1856, and later chap, xii] DISARTICULATION AT THE HIP 669 by Verneuil. In the account of the operation the admirabledescription of Farabeuf is followed. The same instruments are required as are used in the previousoperation. In addition to those mentioned, an aneurysm-needleand a small scalpel will be needed. Retractors are occasionallyemployed. The position of the surgeon and of his assistants is thesame. The patient is so placed that the pelvis rests uponthe extreme end of the table and the trunk evenly upon theback. The Operation.—(1) No tourniquet is
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