346 



APPLIED ANATOMY. 



surrounded. To remove the diseased parts without inflicting avoidable injury 

 requires an exact and skilful operator who has a precise knowledge of the anatomy 

 of the region. Interference with the sheaths of the tendons will result in stiffness 

 and loss of control and power in the hand. 



Maisonneuve, Boeckel, and Langenbeck operated through a single dorsal in- 

 cision along the radial side of the extensor indicis tendon. As this incision was 

 found to give insufficient room, Lister, in 1865, advised an additional incision along 

 the ulnar border. Oilier, of Lyons, modified Lister's radial incision by carrying it 



FIG. 358. Excision of wrist, showing structures involved and Ollier's incisions. The solid line indicates the dorsal 

 radial incision and the dotted line the palmar ulnar incision. 



nearer the extensor indicis tendon to better avoid injuring the radial artery and the 

 insertion of the extensor carpi radialis brevior tendon. Oilier also carried his incision 

 somewhat higher on the wrist and raised the tissues with a periosteal elevator, and 

 divided no tendons. 



Ollier's Operation. Radial Incision. From a point on the dorsum of the 

 wrist midway between the styloid processes, downward and outward alongside of 

 the extensor indicis tendon to the junction of the middle and lower thirds of the 

 metacarpal bone of the index finger (Fig. 358). 



