274 SURGICAL ANATOMY OF 



tween the flexor longus digitornm and the flexor longus 

 pollicis tendons, having vense comites on each side, and 

 the posterior tibial nerve behind it. 



Ligature of the Posterior Tibial Artery at the Inner 

 Malleolus. This vessel is easily reached, but the incision 

 must be made carefully, as there is a risk of dividing it 

 in overcoming the resistance of the internal lateral liga- 

 ment. An incision about two inches and a half in 

 length is to be made through the integument, midway 

 between the inner malleolus and the tuberosity of the 

 os calcis. After the dense aponeurosis is exposed it 

 should be cautiously divided, when the vessel will be 

 seen surrounded by vena3 cornites, and in order to avoid 

 the nerve, which lies posteriorly, the needle should be 

 passed from the heel towards the ankle. 



The Dorsum of the Foot. The chief points to be ob- 

 served in the surface markings of the dorsum of the foot 

 are those connected with the prominent points of its 

 skeleton. For the performance of the several amputa- 

 tions and disarticulations, certain landmarks are neces- 

 sary to guide the operator in finding the articulation he 

 desires to open. Thus, a line drawn from the depres- 

 sion on the inner side of the foot, immediately between 

 the inner cuneiform bone and the great toe, to the poste- 

 rior edge of the tuberosity of the fifth metatarsal bone, 

 indicates the course of an incision, such as would expose 

 the tarso-metatarsal articulation. 



Again, the tubercle of the scaphoid on the inner side, 

 and a point midway between the outer malleolus, and the 

 tuberosity of the fifth metatarsal bone, which is the 

 situation of the articulation between the cuboid and os 

 calcis, indicates a line of incision which would open the 

 medio-tarsal joint. 



