534 



SURGICAL APPLIED ANATOMY. [Chap. xxin. 



f- 



become inflamed. The best position, therefore, for 

 bone disease, with reference to the question of exten- 

 sion, would be in the hinder parts of either the 

 ,., os calcis or astragalus, 



and one of the worst 

 positions would be as- 

 sumed by disease in- 

 volving the scaphoid 

 bone. 



Symc's ampu- 

 tation at the ankle. 

 In the heel-flap are 

 cut the integuments, 

 the external saphenous 

 nerve and vein, the 

 peroneus longus, pero- 

 neus brevis, tibialis 

 posticus, flexor longus 

 digitorum,flexorlongus 

 pollicis,tendo Achillis, 

 points of origin of the 

 flexor brevis digitorum 

 and of the two ab- 

 ductor muscles and 

 the internal and ex- 

 ternal plantar arteries 

 and nerves. 



In the dorsal flap 

 are cut the integu- 

 ments, tibialis anticus, 

 extensor commimis di- 

 gitorum, extensor pro- 

 prius pollicis, peroneus 

 tevtius, anterior tibial 

 vessels and nerve, mus- 

 culo-cutaneous nerve, and internal sapheuous nerve 

 and vein. The position of the principal structuree 



Fig. 57. Syme's Amputation (Agatz). 



a, Tibia; 6, fibula: c, tibinlis anticus: d, 

 extensor propriue poliicis; e, extensor 

 corcrannig digitorum : /, jicroneus tertius; 

 g. flexor longus pollicis; It, tibialis posti- 

 cus ; !, flexor lungtu disrnonim ;j, peroneus 

 hrevis : k, peroneus longus : I, tendo 

 Aoliillis; m, some muscles of the sole that 

 are not usually left in tliis operation ; n, 

 anterior tibial vessels : n, posterior tibial 

 vessels ; p, posterior tibial nerve. 



