Ttie A?m. 



61 



Amputation through the arm may be performed, 

 in the upper half, by means of antero-posterior flaps, 

 and, in the lower half, by the circular method. In the 

 latter operation, the anterior portion of the flap should be 

 somewhat elliptical in shape, so that, the flap would be 

 longer over the biceps to allow for the retraction of this 

 muscle, since this is the only muscle that is unattached to 

 the bone in this situation. Lastly, in amputation through 

 the humerus in young patients, a second operation may 

 sometimes be called for, since the bone receives its growth 

 principally from the upper epiphysis, and grows at a 

 greater rate than the surrounding soft parts. 



