A Text-Book of Operative Surgery, Covering the Surgical Anatomy And Operative Technic Involved in the Operations of General Surgery. Written for Students And Practitioners

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Incision. — Begins just above the carpo-metacari)al joint-hne, in the mid-dorsal aspect of the metacarpal — [lassing into the "snuff-box," if at all, wiih great care and, at first, very superficially, on account of the radial artery.
The incision then passes down the center of the dorsum of the thumb to the neck of the metacarpal — and here divides into the two limbs of an oval, which part to encircle the head of the metacarpal, crossing the palmar aspect of the thumb on a level with the free e
...dge of the web — the outer (radial) of the diverging limbs following the dorsal aspect a little further down before sweep- ing over the lateral aspect than does the inner (ulnar) limb (Fig. 259, N).
Operation. — This incision is deepened on the line of the retracted skin and fascia. The extensor tendons of the first and second phalanges are cut as long as possible, so as to be sutured into the wound. The dorsum and sides of the metacarpal are cleared of soft parts, hugging the bone. The thumb is extended and abducted and the muscles attached to the base of the first phalanx are divided near the sesamoid bones, preserving the thenar muscles as far as possible.


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