494 SURGICAL APPLIED ANA TOMY. [Chap. xxn. 



the bone. It thus happens that the risk of wounding the 

 artery is greater when the tibia is sawn than when the 

 lower part of the femur is being removed. Excision of 

 the knee is, to a large extent, replaced by arthrectomy. 

 Amputation through the knee-joint. By 

 single anterior flap. In fashioning the anterior flap 

 (which is composed only of integument), and in 

 opening the joint, the patellar plexus of nerves, the 

 superficial branches of the plexus of arteries, the 

 ligamentum patellae, and the anterior part of the 

 capsule will be cut. Nearer the condyles of the femur 

 the anastomotic and the two superior articular arteries 

 will be divided. The long saphenous vein and nerve 

 will be divided at the inner angle of the flap. On the 

 cut surface made by the posterior incision will be found 

 divided the sartorius, gracilis, and semitendinosus, the 

 semimembranous, both heads of the gastrocnemius, 

 the popliteus, plantaris, and biceps. The popliteal 

 vessels, the sural arteries, the short saphenous vein, 

 the internal and external popliteal nerves, the external 

 saphenous and the small sciatic nerves will also be 

 found divided in the same incision. The most 

 convenient amputation at the knee-joint is by equal 

 lateral flaps (Stephen Smith's operation). 



CHAPTER XXII. 



THE LEG. 



Surface anatomy. The anterior border of the 

 tibia can be felt in its entire length, forming, as it does, 

 the prominence of the shin. It should be remembered 

 that this border presents a somewhat flexuous course, 

 being cui-ved outwards above and inwards below. The 

 broad internal surface of the bone is subcutaneous, 

 and the internal border can be followed from the 

 tuberosity to the mallcolus. The head of the 



