Volume 1
The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.
- Date:
- 1895
Licence: Public Domain Mark
Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
175/1272 (page 143)
![the body, and at the same time rotates it inwards so that the trochanter shall not catch the knife ; the heel of the knife is then passed over the trochanter, and the posterior flap rapidly cut by carrying- the knife downwards and back- wards through the thick muscles in this situation. The posterior flap may be about four inches in length ; but this must, of course, vary according to the length of the anterior flap. When the amputation is performed on the riyhl side, the anterior flap is made by entering the knife just above the tuberosity of the ischium, and bringing it out two fingers' breadth below the anterior superior spine of the ihum (Fig. 81) ; the remaining steps of the operation being performed as in the last case. In transfixing from the inner side, if Fig. S'_'.—Amputation at Hip-joint: Compression of Femoral Artery in Anterior Flap. the point of the knife be directed too much upwards, it may enter the thyroid foramen. In order to avoid the inconvenience caused by standing in a cramped posi- tion between the patient's thighs, many Surgeons transfix from the outer side on the right limb as well as on the left. In consequence of the extent to which the limb that is about to be removed may have been injured, or encroached upon by disease, it is not always easy to make the anterior flap of the size or shape described. A little management on the part of the Surgeon will, however, enable him to take the requisite amount of covering from the outer or inner parts by inclining the ])oint or the heel of the knife downwards, as the case may require ; or he*may make the anterior flap by dissection, instead of by transfixion. When the femur is entire and unbroken. Assistant No. 2 uses it as a lever, bringing the lower end of it in the second stage of the operation](https://iiif.wellcomecollection.org/image/b2197407x_0001_0175.jp2/full/800%2C/0/default.jpg)
