284 SURGICAL ANATOMY OF 



with the cuboid is doubly oblique. After disarticulation, 

 the posterior flap should extend as far as the web of the 

 toes. 



Parts Divided in Hey's Amputation. In the anterior 

 flap, the integument beginning from the outer side, the 

 dorsal veins of the foot, the internal and external divis- 

 ions of the musculo-cutaneous nerve, the internal and 

 external cutaneous nerves, the dorsal aponeurosis, exten- 

 sor brevis digitorum, tendon of peroneus brevis, tendon 

 of extensor communis digitorum, anterior tibial vessels 

 and nerve, tendons of extensor proprius pollicis and tibi- 

 alis anticus, dorsal ligaments, and the articulation. 



In the posterior flap, plantar ligaments, tendon of 

 peroneus longus, external and internal plantar vessels 

 and nerves, interossei, the flexor brevis, abductor and 

 adductor pollicis, transversus pedis, tendons of long and 

 short flexors of toes, and flexor longus pollicis tendon, 

 djgital vessels and nerves, plantar fascia and integument. 



Chopart's amputation, or the inedio-tarsal, consists of 

 opening the articulation by a semilunar incision, extend- 

 ing between the joint behind the tubercle of the scaphoid 

 internally and a point midway between the external 

 malleolus and the tuberosity of the fifth metatarsal bone; 

 externally, the posterior flap is to be brought well up to 

 the web of the toes. 



It is important to remember that the direction of the 

 articulating surface is changed in flexion or extension : 

 in flexion the astragalus and calcis are in the same line, 

 in extension the calcis is at least a quarter of an inch in 

 front ; the head of the astragalus presents a large globu- 

 lar surface, whilst the anterior articulating surface of the 

 calcis is concave. 



The following directions for discovering the articula- 



