. Text-book of operative surgery . ncave anteriorly, the line of the Joint is^^J shaped. If the knife be carried too far back, it will open the astragalo-calcaneanJoint. The Chief stnactures which unite the bones are the inferior calcaneo-scaphoid andthe calcaneo-cuboid ligaments. When the foot has been disarticulated the extensor tendons (tibialis anticus, theextensor longus digitorum, and the peroneous tertius) should be sutured to the dorsalperiosteo-capsular Aap, the foot being held at right angles. Hoffmann 1 has described a modification of Choparts Operation, suggested byWitzel, whe
. Text-book of operative surgery . ncave anteriorly, the line of the Joint is^^J shaped. If the knife be carried too far back, it will open the astragalo-calcaneanJoint. The Chief stnactures which unite the bones are the inferior calcaneo-scaphoid andthe calcaneo-cuboid ligaments. When the foot has been disarticulated the extensor tendons (tibialis anticus, theextensor longus digitorum, and the peroneous tertius) should be sutured to the dorsalperiosteo-capsular Aap, the foot being held at right angles. Hoffmann 1 has described a modification of Choparts Operation, suggested byWitzel, where the toes are retained. A rectangular area of skin containing the sinusesis first excised from the dorsum, the ?jones are then disarticulated at Choparts Joint,and at the metatarso-phalangeal joiat (or the metatarsals sawn across), and the toesalong with the skin of the sole are retained : the latter is redundant and folded atfirst, but soon shrinks. 43. Intertarsal Amputation. When the soft parts are insufficient for a Choparts. Fio. —Siibastragaloid disarticulation (Malgaigiie, Textor). amputation, the articular surfaces of the astragalus and os calcis are sawn off afterdisarticulating as in Choparts Operation. A movable stump may still be obtained,as the capsule of the ankle-joint (which does not extend farther forwards than 1 the cartilage of the head of the astragalus) need not be opened. 44. Suhastragaloid Disarticulation (MaJgaigne, Textor) (Fig. 215). A racket-shaped incision is made, the handle being placed horizontally immediately behind andbelow the tip of the external malleolus, and the circular incision carried round thefoot at the level of Choparts Joint. The incision is somewhat similar to that ofPerrin and Chauvel, and is closely allied to Faraboeufs internal plantar Aap. The Joint between the astragalus and scajjhoid is opened from the dorsum withoutopening the calcaneo-cuboid Joint. A narrow knife is then passed backwards andslightly upwards
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