. Text-book of operative surgery . eseprinciples we describe the different methods. The question is still undecided whether or not it is advantageous, provided theknee-joint is healthy, to retain the capsule, while the same remark applies to thepreservation (or non-preservation) of the patella. The latter is always of tise whenan artificial limb is fitted. In view of the comparatively small amount of musculartissue in the region of the knee, the fiap consists merely of skin and fascia, at least onthe anterior surface. The oblique incision is to be preferred as the large size of thecondyles of
. Text-book of operative surgery . eseprinciples we describe the different methods. The question is still undecided whether or not it is advantageous, provided theknee-joint is healthy, to retain the capsule, while the same remark applies to thepreservation (or non-preservation) of the patella. The latter is always of tise whenan artificial limb is fitted. In view of the comparatively small amount of musculartissue in the region of the knee, the fiap consists merely of skin and fascia, at least onthe anterior surface. The oblique incision is to be preferred as the large size of thecondyles of the femur requires that special care be taken to provide an ample coveringof skin. 49. Disarticulation at the Knee (Figs. 228, 229). This is performed if theJoint is in a healthy State, but amputation higher up is necessary if it is diseased. Byretaining the capsule of the Joint along with the synovial membrane (Socin) a freelymovable covering for the stump is provided : but the same can be obtained if the flaps Tnbercle of Fig. 228.—Disarticiilatiou at the knee-joint. are carefully stitched and asepsis is complete. Owing to the great breadth and thick-ness of the condyles there must be no lack of skin taken from the sides. For thisreason the oblique incision is more suitable than any of the liap methods. Anexcellent stump is got if aseptic healing occurs. (a) Retaining Capsule and Patella. An anterior Aap is obtained by making anoblique oval incision, beginning posteriorly opposite the level of the Joint, andending anteriorly four fingers-breadth below the tubercle of the tibia. If the leg beheld with the knee half-bent (making an angle of 135° with the thigh), the incisionfalls in the continuation of the long axis of the thigh (Fig. 228). After dissecting upthe skin and fascia, the capsule with the ligamentum patellce, the semilunar cartilages,and lateral ligaments, are cut through anteriorly and lateraliy; the crucial ligamentsare separated from the spine of the t
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