A manual of operative surgery . uscles. The white line which is said to mark thisgap is not to be relied upon. There may be notrace of such a line ; it may be very faintlyindicated, or the position of the interspace may bemarked by a yellow fatty line. The white lineis best seen in young muscular subjects. Inthe aged and wasted it is usually absent. Incorpulent subjects the linear deposit of fat iscommonly white line, when it does exist, indicates the tendinousmargin of the flexor carpi ulnaris. This tendinous tissue belongsto the tendon of origin of the muscle, and not to that of
A manual of operative surgery . uscles. The white line which is said to mark thisgap is not to be relied upon. There may be notrace of such a line ; it may be very faintlyindicated, or the position of the interspace may bemarked by a yellow fatty line. The white lineis best seen in young muscular subjects. Inthe aged and wasted it is usually absent. Incorpulent subjects the linear deposit of fat iscommonly white line, when it does exist, indicates the tendinousmargin of the flexor carpi ulnaris. This tendinous tissue belongsto the tendon of origin of the muscle, and not to that of the inser-tion, as usually stated. At the level of the centre of the forearmthere is seldom any trace of the tendon of insertion. A faintvariety of the white line is sometimes produced by an unusualintermuscular septum. The flexor carpi ulnaris is much more closelyadherent to this septum than is the flexor sublimis, and whenthe fascia is divided the septum adheres to the former muscle, thusproducing a species of fascial FIG. 317. — LIGATUREOF THE RIGHT ULNAR AT THEMIDDLE THIRD OFTHE FOREARM. Superficial Wound.—A, Fascia; b, Pal-mares longus; C,Flex. ulnaris; b,Superficial vein. CHAP. II] LIGATURE OF THE ULNAR 351 The interspace between the two muscles in question is not quitestraight, is not quite vertical when the limb is in position for theoperation. The flexor carpi ulnaris overlaps the flexor sublimis alittle, and the line of the interspace is directed as is shown at a inFig. 319. The fibres of both the muscles follow the long axis ofthe limb. If the division of the deep fascia be exactly in the line of theskin incision, in the line of the artery x, the knife will probablycut upon the flexor carpi ulnaris. By dividing the fascia a little more to the outer side as advised,the knife comes upon the flexor sublimis (Fig. 319), and by workinginwards the oblique gap between themuscles is made out. This gap is alwaysbest demonstrated by the finger. It isofte
Size: 979px × 2553px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
