Annals of surgery . d securingthem at an earl)- stage of the operation; but, in the experiencewhich I have had, is not so easy of execution as I had been ledt believe; the chief difficulty being in disarticulating the headof the femur from the cavity of the acetabulum. When thefemur is sawn at the level of the lesser trochanter, the fragment • rtiort as not to be easily handled, and gives no leverage fordislocating the head of the femur. This difficulty was sogreat, in my last operation, as to require more time than all the AMPUTA TIONS A T THE HIP-JO/XT. 13 rest of the operation. I was not un
Annals of surgery . d securingthem at an earl)- stage of the operation; but, in the experiencewhich I have had, is not so easy of execution as I had been ledt believe; the chief difficulty being in disarticulating the headof the femur from the cavity of the acetabulum. When thefemur is sawn at the level of the lesser trochanter, the fragment • rtiort as not to be easily handled, and gives no leverage fordislocating the head of the femur. This difficulty was sogreat, in my last operation, as to require more time than all the AMPUTA TIONS A T THE HIP-JO/XT. 13 rest of the operation. I was not unmindful of the directionsgiven by Prof. Wyeth to lift the end of the bone in the directionof the patients naval, and, dividing the cotyloid ligament pos-teriorly ; but, in spite of this, I almost despaired of ever gettingthe head of the bone out. Perhaps a good deal of my difficultywas owing to a want of skill, but I was consoled by the remem-brance of witnessing Prof. Wyeth, himself, one year previous, at. Fig. 2. Ideal method of Amputation at the Hip-joint. Louisville, Ky., having a good deal of the same difficulty,when he gave a demonstration of the operation upon thecadaver before the Mississippi Valley Medical Association. In the operation done by Keen, of Philadelphia, in Februarylast, at which Prof. Wyeth was present, the operation requiredfifty minutes for its performance; how much of the time wasconsumed in enucleating the head of the bone is not stated. Itis reported, however, that Prof. Wyeth suggested a low amputa-tion of the bone. This is an excellent suggestion, as it leaves a 14 J. B. MURDOCH. longer lover for manipulating the fragment. But let me ask,why saw through the bone at all ? Why not go right on anddisarticulate? With the whole limb to act as a lever this iseasily accomplished, and, if Wyeths tourniquet has beenproperly applied, it can be trusted to control the hemorrhageuntil the vessels are secured. Wyeths method of controlling the hemorrhage during
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