Chap. XII.] 



THE ARM. 



209 



the substance of the triceps, and immediate contact 

 of the bones be consequently prevented. 



Amputation through the middle of the 

 arm. Circular method : The parts divided in this 

 amputation are fully shown in Fig. 22. Flap 

 method : Two flaps of about equal size and shape 

 may be cut antero-posteriorly by double transfixion, 

 the arm being well 

 rotated outwards. 

 In the anterior flap 

 would be the biceps 

 and the greater part 

 of the brachialis 

 anticus, with the 

 musculo - cutaneous 

 nerve between them, 

 and a small piece 

 of the triceps from 

 the inner side of 

 the limb. The 



brachial vessels, the 

 median and ulnar 



nerves, and possibly Fig . 22 .-A Transverse Section through the 

 the inferior profunda middle of the Arm (Braune). 



nr+pvtr afp nlcm a > Biceps ; 6, coraco-brachialis: c, brachialis 



;C1 J ) anticus ; d, triceps : 1, brachial artery ; 2, me- 



fouild ill this flap, dian nerve ; 3 ' ulnar nerve ' 4 ' musculo-spiral 



jr ' ner > e. 



about the inner 



angle of the stump. The basilic vein and internal 

 cutaneous nerve lie cut about the inner border of 

 the anterior flap, and the cephalic vein about its 

 outer border. In the posterior flap would be the 

 triceps, any small part of the outer portion of the 

 brachialis not divided in the anterior flap, the superior 

 profunda artery, and the musculo-spiral nerve. If 

 the amputation be lower down in the arm, the ulnar 

 nerve and inferior profunda artery may be found in 

 the posterior instead of the anterior flap. Since the 

 o 



