Report of a committee of the associate medical members of the Sanitary Commission, on the subject of amputations through the foot, and at the ankle-joint.

  • United States Sanitary Commission.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Report of a committee of the associate medical members of the Sanitary Commission, on the subject of amputations through the foot, and at the ankle-joint. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    14/32 (page 14)
    REMARKS. Ill deciding upon the point of amputation, surgeons are verj properly governed by the following simple rules:— 1st, The comparative danger of the operation ; and 2nd, Tlie comparative usefulness of the stump. If there were two given points at which an amputation might be performed, no prudent surgeon would select the one liaving the largest mortality, unless the ultimate advantages were of the utmost importance to the usefulness or happiness of the patient. Of the operations on the foot which we have passed in review, it may be said that in all which involve the parts anterior to the medio-tarsal, or Chopart’s amputation, these two conditions combine to determine the surgeon to save as much of the extremity as possible. The mortality of the operation diminishes and the usefulness of the limb increases in proportion to the amount preserved. There can be no doubt, therefore, that it is the duty of the operator to preserve as much of the anterior portion of the foot as possible. But new and important questions arise when we attempt to decide upon the value of the three remaining operations by the rules proposed. With a view to a proper appreciation of the alleged advantages and disadvantages of these amputa- tions, in order to arrive at correct conclusions as to their com- parative merits, we present the follow'ing summary of opinions by surgical authorities. Chopart's Operation.—Chopart’s operation has now been practised nearly three-quarters of a century, and has been, during the whole period, the subject of severe criticism. On the one hand it is contended that the stump is entirely ser- viceable, that the operation is attended wnth slight mortality, and that by it an important portion of the foot is preserved. Oil the other, it is asserted that the stump is generally tender, very often atfected with incurable ulcers, and, finally, that the extremity of the stump is liable to become the most depending