The principles and practice of surgery : founded on the most extensive hospital and private practice, during a period of nearly fifty years; with numerous plates, illustrative both of healthy and diseased structure / by Astley Cooper ; edited by Alexander Lee.
- Cooper, Astley, Sir, 1768-1841.
- Date:
- 1836-1837
Licence: Public Domain Mark
Credit: The principles and practice of surgery : founded on the most extensive hospital and private practice, during a period of nearly fifty years; with numerous plates, illustrative both of healthy and diseased structure / by Astley Cooper ; edited by Alexander Lee. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
587/1190
![in every instance in which I have performed the amputation through this joint, and every case in which I have seen it done, the recovery of the patient has been speedy and perfect. OF AMTUTATION BETWEEN THE TARSUS AND METATARSUS. As I think it best to saw off that part of the internal cuneiform instruments, bone, which supports the metatarsal bone of the great toe, a saw will be required, as well as a strong catling. A tourniquet should be applied upon the thigh, and the patient Position, should be placed upon a low table in the recumbent posture. The leg and foot being extended, and fixed by an assistant, the Operation, surgeon divides the integument across the dorsum of the foot, commencing at the base of the metatarsal bone of the great toe, and terminating the incision about half an inch beyond that of the little toe ; he then makes a lateral incision on each side, so as to enable him easily to dissect up the flap of integument as far as the joints of the four smaller metatarsal bones, and that part of the internal cuneiform which is on a level with these articulations ; the extensor tendons being next divided, the four small metatarsal bones are bent downwards, and their ligamentous connexions with the tarsal bones cut through with the point of the catling, after which the internal cuneiform bone is sawn through even with the other tarsal bones: the amputation is completed by passing the catling between the separated bones, dividing the flexor tendons, &c., and forming a flap of about equal size to the superior from the integument on the sole of the foot. The anterior tibial on the dorsum pedis, and the two plantar yesse]s arteries of the sole, will most probably require the application of ligatures. The integument is to be brought over the extremities of the Dressin„. bones, and the edges of the wound kept in contact by straps of adhesive plaster, passed from the sole to the dorsum ; the patient is to be placed in bed, and the foot supported by a pillow, until union has taken place.](https://iiif.wellcomecollection.org/image/b28525474_0599.jp2/full/800%2C/0/default.jpg)
