Operative surgery, adapted to the living and dead subject / by C.F. Maunder.

Date:
1860-1861
Catalogue details

Licence: Public Domain Mark

Credit: Operative surgery, adapted to the living and dead subject / by C.F. Maunder. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    scaphoid, as well as the astragalus and calcaneum, to the use of the patient: the flap must be cut in due proportion. Tibio-tarsal Amputation (Syme).—This operation consists in the removal of the whole foot, and of the malleoli and inferior articular surface of the tibia. Two incisions are made, in such a manner as to meet each other at a right angle. The foot being in such position as to be at a right angle with the leg, one incision is to be made through integuments only, in front of the ankle-joint, extending from one malleolus to the other. (See fig. 10, a.) The second is to be begun at one of the former: if on the inner side, at the apex of the internal malleolus; if on the outer side, just in front of the external malleolus,—because the latter being on a plane posterior and inferior to the former, the points of commencement and of ter- mination of the second incision would, if begun at the apex of each malleolus, not be upon the same plane. Commence then the second incision at one of the above points, and carry it downwards to one border of the sole, now across the sole to the other border, and then upwards to join one point of termi- nation of the first or anterior incision, dividing all structures down to the bone. This cut is at a right angle to the sole of the foot, the anterior part of the foot being, as it were, isolated by a rectangular inci- sion. The leg must now be supported at a convenient height, and the foot be firmly held at a right angle to the leg, while the operator effects the most diffi-