POPLITEAL ANEURISM. 



103 



Fig. 33. 



as to get between the tibi- 

 alis anticus and extensor 

 communis digitorum. After 

 the division of the superficial 

 fascia, a proper allowance 

 should be made for the 

 breadth of the tibialis anti- 

 cus, in order to strike the 

 line of division upon the 

 dense fascia between the 

 two muscles. The artery 

 will be found at the bottom 

 of this space, lying on the 

 interosseous membrane. 



At the lower part of the 

 leg a less incision is neces- 

 sary, the vessel being more 

 superficial. The wound is 

 made on the fibular side of 

 the extensor proprius poUi- 

 cis. The vense comites and anterior tibial nerve are to be avoided. 



On the instep the artery may be secured by making an incision 

 on the fibular side of the tendon of the extensor proprius pollicis. 



The 'posterior tibial may be readily tied near the middle of the 

 leg, upon the inner side ; divide the skin, superficial fascia, crural 

 fascia, and some fibres of the soleus, and the leg being flexed, the 

 triceps sura can be pushed aside sufficiently to expose the sheath of 

 the vessels ; the artery 



is to be carefully ex*- 

 cluded from the veins 

 and nerve. 



At the ankle the 

 operation is simple. 

 A semilunar incision 

 is made, posterior to 

 the internal malleolus, 

 through the skin and 

 superficial fascia, and 

 a thick aponeurosis ; 

 this exposes the sheath 

 of the vessels. The 

 veins and nerve are to 

 be excluded. 



Fig. 34. 



