AMPUTATION AT THE HIP JOINT. 



107 



ration are the injuries to vessels and nerves, by transfixion and 

 oblique division. 



AMPUTATION AT THE HIP JOINT. 



This operation is rarely necessary, and is always severe and dan- 

 gerous ; it should never be performed for disease of the joint. The 

 patient is to be placed on a table, with his pelvis projecting from the 

 edge. The artery is compressed by an assistant, who must be 

 ready to thrust his fingers in the wound formed during the formation 



Fig. 38. 



of the anterior flap, so that he can grasp the end of the vessel, as 

 soon as it is cut. The knife is entered about middle way between the 

 trochanter major and the anterior superior spinous process of the 

 ilium. By cutting downwards, the anterior flap is formed. The head 

 of the bone is then disarticulated, and the blade of the knife being 

 then placed behind the bone, is carried downwards and backwards, 

 so as to form a posterior flap ; the vessels are to be rapidly secured, 

 and the flap managed as in all other flap operations. By some the 

 formation of a lateral flap is preferred. Very often the selection of the 

 flap will depend upon the character of the wound which may render 

 the operation necessary. 



AMPUTATION OF THE LEG. 



The length of the stump will, in some measure, depend upon the 

 kind of artificial limb to be used. If the patient is to rest upon his 

 knee, the stump should be short, in order, to be bent at right angles. 



Circular method. — The tourniquet having been applied, the in- 

 teguments are to be divided, dissected up, and turned back for two 

 inches ; the muscles are to be divided, down to the bone, by a 



