Hand-book of surgical operations / by Stephen Smith.

  • Smith, Stephen, 1823-1922.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: Hand-book of surgical operations / by Stephen Smith. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    Fig. 113. base of the external flap, open the joint with the point rather than the blade; if the line of the articulation is not found readily, soek it from before backwards, along the end of the me- tacarpal bone ; if the knife is kept close to the first metacarpal bone at its upper extremity, the radial artery may be avoided; if cut, it must be at once tied. Modifications.—Velpeau made a dorsal incision from the styloid process of the radius to the com- missure between the thumb and finger, divid- ing the integuments, tendon of the Ion? extensor, and part of the interosseous muscle; the joint is then opened, and the metacarpal bone dislocated and dissected out; the palm is not wounded. Oval Method.—Scoutetten's method modified by Malgaigne (Ber~ nard and Huette) :—(Fig. 114.) The hand held in a position between supination and prona- tion, make an incision along the dorsal sur- face of the metacarpal bone of the thumb, commencing six lines above its articulation, a, with the trape- zium, and extending through all the tissues down to the bone, to the inner side of the head of the first pha- lanx of the thumb, on a level with the com- missure, b, between the thumb and index finger. Then, carry- ing the hand into a tinue the incision around the palmar surface of the phalanx to its outside, c, and thence to the dorsum of the metacarpal bon°, to meet the first incision about at its middle. Detach the muscles and integuments from either side of the bone, and open the articulation from its dorsal aspect (Fig. 115, a); then, endeavoring to dislocate the bone outwards, complete the division of its remaining attachments.