A manual of operative surgery . palmararch and the transverse partof the superficial arch areremoved with the hand. 4. Dubrueils Operation byan External Flap.—This inge-nious method is thus describedby Chalot (Chirurgie Ofteratoire,1886), who states that he has seen excellent results from this operation in the hands of ProfessorDubrueil:— The incision is commenced on the back of the wrist, at the junc-tion of the outer with the middle third, and at a point half a centimetrebelow the line of the wrist-joint. It is thence carried downwardstowards the thumb upon the dorsal aspect of the limb, and
A manual of operative surgery . palmararch and the transverse partof the superficial arch areremoved with the hand. 4. Dubrueils Operation byan External Flap.—This inge-nious method is thus describedby Chalot (Chirurgie Ofteratoire,1886), who states that he has seen excellent results from this operation in the hands of ProfessorDubrueil:— The incision is commenced on the back of the wrist, at the junc-tion of the outer with the middle third, and at a point half a centimetrebelow the line of the wrist-joint. It is thence carried downwardstowards the thumb upon the dorsal aspect of the limb, and is made tocross the first metacarpal bone transversely about its middle. Theincision now follows the inner part of the thenar eminence, andterminates at a point diametrically opposite to the point at whichit was commenced. This represents the outline of the external orthenar flap (Fig. 364, g). This flap is now dissected up to its base, and is made to includeas much of the thenar mass of muscle as is possible. The skin and. FIG. 368.—DISARTICULATION AT THE WRISTBY LONG PALMAR FLAP. 516 AMPUTATIONS [part vr soft parts internal to the flap are then divided in a circular mannerthrough an incision on a level with the base of the flap. Disarticu-lation having been effected, the operation is complete. The thenarflap is brought transversely across the face of the radius and ulna,and is there secured. Comment.—-Disarticulation may also be effected by a long-dorsal flap. This flap has its base at the styloid process andits extremity opposite the centre of the metacarpus. Themethod has little or nothing to recommend it. The flap only of skin and tendons, is very retractile, and verypoorly supplied with blood. It affords a scanty covering forthe bones, and either the integuments or the underlying tendons,are apt to slough. If the flap be composed of skin only, itsfate is nearly certain. The amputation by equal palmar and dorsal flaps correspondsto the circular method,
Size: 1296px × 1929px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
