. Minor and operative surgery, including bandaging . second cuneiform bone, which occupies a position higheron the foot than the other articulations. The disarticu-lation may also be facilitated by forcibly depressing the MEDIO-TA ESAL AMPUTA TION. 517 anterior portion of the foot. After all the joints havebeen opened, the knife is passed behind the ends of themetatarsal bones, and a plantar flap is cut from withinoutward, following the line of the incision previouslymarked out. The plantar flap may be cut from withoutinward if preferred. Tarso-metatarsal Amputation (Heys).—The line ofincision
. Minor and operative surgery, including bandaging . second cuneiform bone, which occupies a position higheron the foot than the other articulations. The disarticu-lation may also be facilitated by forcibly depressing the MEDIO-TA ESAL AMPUTA TION. 517 anterior portion of the foot. After all the joints havebeen opened, the knife is passed behind the ends of themetatarsal bones, and a plantar flap is cut from withinoutward, following the line of the incision previouslymarked out. The plantar flap may be cut from withoutinward if preferred. Tarso-metatarsal Amputation (Heys).—The line ofincision and the steps of this operation are similar to thosein Lisfrancs amputation, with the exception that Heysawed off the projecting portion of the internal cuneiformbone after disarticulating the metatarsal bones. Thismodification, although it improves the appearance of thestump, possesses no advantages over the latter procedure. Medio-tarsal Amputation (Choparts).—In this ampu-tation the disarticulation is through the joints formed by Fig. Choparts amputation. (Bryant.) the astragalus and calcaneum behind and the scaphoid andcuboid in front. An incision is made from the tubercleof the scaphoid across the dorsum of the foot an inch infront of the head of the astragalus to the lower and outerborder of the cuboid (Fig. 418, B). The plantar flap isnext marked out by an incision beginning and ending atthe same points as the first incision and crossing the soleof the foot four or five finger-breadths nearer the toes 518 AMPUTATIONS. (Fig. 420, A). The dorsal flap is next dissected up, andafter the tendons and fascia have been divided the jointis opened and a plantar flap is cut from within outward,following the line of the previously marked-out plantarincision (Fig. 421). Subastragaloid Amputation.—In this amputation allthe bones of the foot are removed except the incision is made, beginning an inch below the tip ofthe external malleolus, which is carried for
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