The double-flap and circular amputations contrasted : being an abstract of a first prize essay at the University of Edinburgh / by F.N. MacHardy.

  • MacHardy, F.N.
Date:
1841
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Licence: Public Domain Mark

Credit: The double-flap and circular amputations contrasted : being an abstract of a first prize essay at the University of Edinburgh / by F.N. MacHardy. 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.

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    Klein, (1) Liston, (2) and Cooper, (S') have advocated anliro- posterior flaps, which, though of general application, still possess the disadvantage of favouring a protrusion of bone, when formed at the insertion of the deltoid muscle ; but by there adopting the lateral flaps, as employed by Garengeot, (4) and Mr Morgan (5) at Guy’s, this occurrence will be entirely prevented. Hey (6) deemed the flap unnecessary in the arm, and many ope- rators are of opinion that a sufficient stump can be effected by the circle; but even here there are living monuments of its defi- ciency, (7) such as have never yet been recorded of the flap. Second, British surgeons seldom hesitate to amputate the fore- arm at the lower third; but the continental, and especially the French operators, object to this selection, on account of the parts being involved in tendinous and fibrous structures; but were they less seldom to adopt consecutive union, their fears might be dis- pelled, and their objections removed. Malgaigne (8) declared that Lisfranc’s operation at the wrist was showy, but less advantageous in its results than the circular amputation; but Sir Astley Cooper (9) relates fatal cases from the latter; while Liston, (10), Lawrence, (11) Hey, (12) Ward- rop, (l3) and Cooper, (14) have had ample satisfaction of stumps from the former. Lawrence (15) has amputated immediately below the elbow joint; Tyrell, ^^16) 3| inches under it; Ballingall, (17) at the mid- dle of the forearm ; and Sir Anthony Carlisle, (18) 4 inches above the wrist; the choice depending much on the nature of the injury, 50, p. 373; Glasgow Med. Jour. l828, v. 1, pp. 117, 331, 406; 1829, V. 2, p. 155; 1830, pp. 223, 233 ; 1831, v. 4, p. 100. (l) Bract. Ansic. der. chir. oper. 44. (2) Lond. Med. Gaz. l829, V. 4, p. 350. (3) Lancet, 1826-7, v. I2,p. 61. (4) Mem. de I’Acad. de chir. t. 5, l2mo. (5) Lancet, 1825-6, v. 10, p. 730. (6) Surg. 1810, p. 526. (7) Lond. Med. Chir. Trans, v. l6, Langstaft’; Lancet, 1834-5, v. 2, p. 548. (8) Sam. Cooper’s First Lines, p. 717. (9) Lancet, 1826, v. 3 and 4, p. 67. (lO) Operat. Surg. p. 305. (11) Lancet, 1827-8, v. 2, p. 472. (12) Ibid. 1824, V. 5, p. 59. (13) Ibid. 1825-6, v. 10, p. 351. (14) Lond. Med. Gaz. 1829, v. 3, p. 791. (l5) Lancet, 1831-2, V. 2, p. 223. (l6) Ibid. 1826, v. 3 and 4, p. 203. (17) Clin. Lect. Edin. Infirmary, July, 1828. (18) Lond. Med. Gaz. 1829- 30, V. 2j p. 319.