. Operative surgery. FiG. 601.—Sawn bones in Le Forts modification. Fig. 603.—Appearance of stump. tragalus with strong forceps, make tense and cut the ligaments connecting itwith the bones above, and then remove it. Push down the os calcis, and witha narrow saw remove its upper third horizontally from behind forward, be-ginning just above the insertion of the tendo Achillis. Saw off the malleoli. Fig. 603.—Sawn bones in Brunss modi-fication. Fig. 604.—Esmarehs incision. and the articular surface of the tibia also horizontally (Fig. 601); place thesawed surfaces in appositio
. Operative surgery. FiG. 601.—Sawn bones in Le Forts modification. Fig. 603.—Appearance of stump. tragalus with strong forceps, make tense and cut the ligaments connecting itwith the bones above, and then remove it. Push down the os calcis, and witha narrow saw remove its upper third horizontally from behind forward, be-ginning just above the insertion of the tendo Achillis. Saw off the malleoli. Fig. 603.—Sawn bones in Brunss modi-fication. Fig. 604.—Esmarehs incision. and the articular surface of the tibia also horizontally (Fig. 601); place thesawed surfaces in apposition, and dress in the usual manner. This modifica-tion permits the preserved fragment of the os calcis, when placed in position,to maintain the same axis relative to the end of the stump that it held in thefoot; consequently, the direct pressure is received upon integumentary AMPUTATION AT THE LOWER EXTREMITY. 516 covering already adapted to tliat purpose (Fig. G02). It also provides abroader support, and for these reasons is regarded by some as superior tothe Piroffoff method.
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