Volume 1

A manual of operative surgery / by Frederick Treves.

  • Sir Frederick Treves, 1st Baronet
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: A manual of operative surgery / by Frederick Treves. Source: Wellcome Collection.

    787/808
    damaged if the whole operation be carried out with a sharp- pointed instrument. If it be necessary to divide one tendon and not the other, the two structures should be exposed through a small incision, and the selected tendon drawn forwards and divided. The elaborate methods given for the subcutaneous division of a single tendon behind the malleolus are of no practical value. If one or both of the peronei be divided below the malleolus, it is as well to expose the tendons through a small incision, rather than cut blindly with a hidden knife. The peroneus brevis in the foot lies above the peroneus longus. Extensor Longus Digitorum and Peroneus Tertius.— The extensor tendons can be conveniently divided in front of or just below the ankle. In the latter situation there is greater risk of injuring the dorsalis pedis artery. The patient lies upon the back, with the foot extended. The surgeon places himself to the inner side of the hmb. An assistant grasps the leg and foot. The tenotome is entered upon the inner side, between the tendon of the extensor proprius pollicis and the tendons to be divided. The usual precautions are observed. The blade is guided beneath the tendons, and the operator cuts towards the skin. The assistant should take more care to prevent the foot from falling suddenly after the tenotomy than to put the tendons upon the stretch during the section. The knife must be kept close to the tendons, and as super- ficial as possible. At the ankle the anterior tibial vessels lie beneath the extensor proprius pollicis. On the dorsum of the foot the artery lies to the outer side of that tendon. If the knife be not allowed to pass deeply, the blood-vessels are in no great danger. Hamstring Tendons.—The biceps tendon can be very readily felt upon the outer side of the popliteal space. Just behind it, and along its inner border, lies the peroneal nerve, which can be easily defined and rolled under the finger. Of the semi-tendinosus and semi-membranosus, the former tendon is the nearer to the middle line of the space, is more
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