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Show ARll'i'TAIIOX UF IKE T0128 A51) FINGERS.) ABIPUTATION or THE "[0133 mm r1xeeas.""‘ ~LIJ Theamputation of the toes and fingers is done at the joints, and the manner is this- / i :2. Then the flaps are to be dissected bad: the metatar. sal bone of the great toe is to be separated from the next, by passing the knife betwixt them; and now, notching upon the square head of the metacarpal hone, where it unites with the i 'm‘ carpus, we may press it down and uniix it. I'Y'va/ my» r anal-m .. \_. \ ".7. "-3- ~26 I . The tendons must be cut short, so as not to lie exposed in the wound. 3. The artery which bleeds on the fore-part, of the foot, is" the extremity of the tibial artery, where it is passing betwixt the head of the metatarsal bones of the great too and the second toe. The lesser artery in the sole, is the internal plantar artery. 4:. The arteries being secured, the llaps are simply brought together, and secured with straps, compresses, and a roller. 1. Instead of the simple circular incision, a slightly semi- eircular incision is made on both sides of the joint, the angle of their meeting terminating over the middle of the joint. 2. Dissecting these flaps slightly from the joint, and pull. ing the skin upward at the same time, he cut above and below, and then bending the finger to ascertain the middle of the joint, we cut down on the lateral ligaments of one side of the joint. This gives the head of the bone freedom; and upon cutting the ligament on the other side, the finger is se- parated. 3. As the arteries are generally in an enlarged and active state from the disease, they may require to be tied. It should he done with the dissecting forceps. If the skin has been neatly cut, it requires only to be put together with one adhe» sive strap, and the hand bound up, AMI'UTATION ABOVL THE ELBOW. THIS is the most simple operation in surgery. Formed with the double circular incision. It is per- If we take care H mm M099". 3 |
