The practice of surgery . the Elboio-Joint. If space enough be left on the forearm, in extensive disease or injuryof that part, the humerus need not be interfered with. An excellentoperation may be done at the elbow ; making a single flap in limb is steadied, with the hand in a state of supination. Transfixionis made, by passing the knife over the condyles, in front of the joint;and, by cutting downwards and outwards, a large and suitable flap isconstructed. With a circular sweep, the integuments behind aredivided; and disarticulation is then effected. The olecranon may besawn across
The practice of surgery . the Elboio-Joint. If space enough be left on the forearm, in extensive disease or injuryof that part, the humerus need not be interfered with. An excellentoperation may be done at the elbow ; making a single flap in limb is steadied, with the hand in a state of supination. Transfixionis made, by passing the knife over the condyles, in front of the joint;and, by cutting downwards and outwards, a large and suitable flap isconstructed. With a circular sweep, the integuments behind aredivided; and disarticulation is then effected. The olecranon may besawn across; or, extending the forearm, this process may be whollyremoved, the attachment of the triceps having been severed. The flapis then suitably adjusted over the trochlea of the humerus. Amputation of the Arm. Pressure is made on the upper part of the humeral, or in the surgeon with his left hand steadies the limb, below the point ofincision; an assistant, seated in front of the patient, supports the hand Fig. Amputation of the Arm. and forearm. The knife is entered, horizontally, over the bone nearits centre, on the side of the limb nearest the surgeon ; the point, havingtouched the bone, is passed lightly round to its anterior surface, bydepression of the handle ; then the handle is raised again to its former 694 AMPUTATION OF THE SHOULDER-JOINT. level, and transfixion is completed. By cutting downwards and out-wards, an anterior flap is formed. The knife is re-entered on the op-posite aspect of the bone, a little lower down : and, after transfixion, isbrought out so as to construct a corresponding flap posteriorly. Theflaps having been retracted, the bone is bared, and the saw applied. Amputation of the Shoulder-Joint. Hemorrhage is restrained by pressure applied to the subclavian,above the clavicle ; by the fingers alone, or by means of the handleof a key, well padded; or by means of any other suitable compressingagent. The pressure is not made downwards merely
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