. Operative surgery. Fig. -Long external-flapmethod. 522 OPERATIVE SURGERY. of the tibia, is carried in a curved direction across tlie outer aspect of thelimb, and then upward in a line diametrically opposite the anterior incisionto a point about an inch and a half below the level of the primary point ofdeparture (Fig. 617, &). Flex the leg and divide the skin and subcutaneous. Fig. 615.—Making the flap. tissue throughout the entire course of the flap with a scalpel. Then dividethe muscles obliquely from above downward and outward down to the boneand interosseous membrane (Fig. 615); sep
. Operative surgery. Fig. -Long external-flapmethod. 522 OPERATIVE SURGERY. of the tibia, is carried in a curved direction across tlie outer aspect of thelimb, and then upward in a line diametrically opposite the anterior incisionto a point about an inch and a half below the level of the primary point ofdeparture (Fig. 617, &). Flex the leg and divide the skin and subcutaneous. Fig. 615.—Making the flap. tissue throughout the entire course of the flap with a scalpel. Then dividethe muscles obliquely from above downward and outward down to the boneand interosseous membrane (Fig. 615); separate them upward carefully tothe point of bone section, cautiously avoiding injury of the anterior tibialartery as it appears in front of the interosseous membrane. The tissuesat the inner side are divided transversely down to the bone by transfixionor otherwise, and separated from the bone up to the line of section. The periosteum of the tibia is divided an inchbelow the line of proposed section bya circular incision, then at each side ofthe bone by a short vertical one; the an-terior and posterior flaps thus formed arepushed upward by the elevator to abovethe saw line; the interosseous membraneis divided, the retractor adjusted, and thebones are sawed in the following manner:Divide the fibula obliquely from abovedownward and inward, about a quarter ofan inch shorter than
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Keywords: ., bookauthorbryantjosephdjosephde, bookcentury1900, bookdecade1900
