File:A text book of operative surgery and surgical anatomy (1878) (14741582596).jpg

Identifier: textbookofoperat00bern (find matches)
Title: A text book of operative surgery and surgical anatomy
Year: 1878 (1870s)
Authors: Bernard, Claude, 1813-1878 Huette, Ch. (Charles) Norton, Arthur T. (Arthur Trehern), 1841-1912
Subjects: Surgery, Operative Surgery, Operative Surgical instruments and apparatus Surgical Procedures, Operative Surgical Instruments Surgical Equipment
Publisher: London : Baillière, Tindall, and Cox
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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e hand. Many surgeons advise, in the disarticulation of the gi-eat toe(fig. 8), the removal at the same time of the head of the meta-tarsal bone, otherwise its prominence produces a deformity whichis painfully irritated by the shoe. (See resections for this specialcase, and for amputation of the metatarsal bones.) 2. Disarticulation of the five toes.—Flap operation. (Figs. 6,7.)(1.) The operator, grasping all the toes in his left hand, makes,with a narrow knife, a semicircular incision extending on the leftfoot, or on the right foot vice versa, from the inner side of thehead of the first metatarsal bone to the outer side of the head ofthe fifth, passing in front of their articulations with the phalanges(fig. 5). (2.) With the point of the knife the articulations are to be suc-cessively opened, and the ligaments divided. (3.) The knife isthen to be glided beneath the bases of the phalanges, to cut withthe full blade a plantar flap (see fig. 6). Fio- l* PI. 24. Fiq^. I. I-UV.5 Fio\ 2.
Text Appearing After Image:
Fkv. ;> AND SURGICAL ANATOMY. 71 PLATE XXIV. TARSO-METATARSAL DISARTICULATION. (HEYS ORLISFRANCS OPERATION.) Anatosit. Fig. 1.—The tarso-metatarsal articulation—formed behind bythe cuboid (a) and the three cuneiforms (&, c, cZ); in front by thefive metatarsal bones—presents an irregularly curved line, thedirection and sinuosities of which should be well understood. Externally the cuboid (a) articulates with the fifth and fourthmetatarsal bones, the line running obliquely from without in-wards, and from behind forwards. This line is slightly broken,the articulation with the fourth metatarsal being more transversethan that with the fifth. About one-tweKth of an inch more infront is the articulation of the third metatarsal bone with theexternal cuneiform (b) ; again, one-eighth of an inch to the rearis the articulation of the second metatarsal bone with the middlpcuneiform (c) ; lastly, about one-third of an inch in front of thepreceding is the articulation of the first meta

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