Caries of the tarsus and ankle-joint.

  • Handyside, P. D. (Peter David), 1808-1881
Date:
[1845]
Catalogue details

Licence: Public Domain Mark

Credit: Caries of the tarsus and ankle-joint. 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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    the side of the instep in a semicircular direction, and then down- wards to the middle line of the foot, terminating immediately in front of the ball of the heel. The extremities of this incision wero met by another and a similar one on the outer aspect of the joint, the second one terminating where the first had been commenced. The flaps were then dissected backwards,—the tendo Achillis was easily divided at its attachment to the os calcis,—and the separa- tion of the foot was readily accomplished. The malleoli were re- moved by the saw, and along with them about one-eighth of an inch of the lower end of the tibia, although the cartilaginous sur- face of the latter was not diseased. Two vessels were tied, these being the anterior tibial and external plantar arteries. After the introduction of the sutures, which were five in number, the flaps covered the bone completely, and the ball of the heel was situated, as in the antero-posterior flap operation, below the extremities of the bones. A bandage was then applied to support the stump. The flaps united almost entirely by the first intention, and a month afterwards the patient could rest his weight on the stump. The ball of the heel continued to form an excellent cushion beneath the ends of the bones. The cicatrice was situated vertically on the fore part of the stump, and it did not exceed two inches in length. The leg was only an inch and a half shorter than the other, so that the patient could walk easily with a high heeled padded shoe. The accompanying sketches represent the line of one of the two similar incisions made in this case, and the form of the stump and leg, as copied from a cast taken upwards of two months after the operation.
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