190 INTRA-PELVIC AMPUTATION OF POSTERIOR LIMBS 



move any dangerous spicules of bone remaining on the 

 stump and see that the latter is safely secured by a cord 

 passing around the leg above the os calcis. Repeat the 

 operation on the other hock in a similar manner using the 

 right hand to guide the chisel. Extend the two limbs into 

 the passage by traction and effect a posterior delivery. 



68. INTBA-PELVIO AMPUTATION OF THE POSTERIOR 

 LIMBS, BREECH PRESENTATION 



FIG. 73 



Uses. The overcoming of dystocia due to a posterior 

 presentation with the hind limbs completely retained in the 

 uterus, the so-called breech presentation, in cases where the 

 deviation can not be readily corrected. 



Technic. Introduce one hand, armed with the embryotomy 

 knife, through the maternal passages until the perineum of 

 the fetus is reached, make a free incision through that 

 region, involving the anus in the male fetus and the anus 

 and vulva in the female, and enlarge the incision sufficiently 

 to admit the operator's fingers into the fetal pelvis. Locate 

 the great sciatic ligament and with the knife or chisel 

 divide it from end to end, thus enlarging the pelvic 

 cavity and giving ample operating room. When this has 

 been severed and sufficient operating room attained, carry 

 the chisel with the hand, place it against the shaft of 

 the ilium as shown between I' I' in Fig. 73, as nearly per- 

 pendicular to the long axis of the iliac shaft as possible and 

 keeping the hand in touch with the chisel blade, have an 

 assistant drive it through the bone until it and its periosteum 

 are completely severed. Revolve the chisel on its long axis 

 and force the cut ends of the bone apart. Disengage the 

 chisel and place it against the symphysis pubis or against 

 the ischium opposite the obturator foramen and dri> e it 



