Amputation at the knee-joint by disarticulation : with remarks on amputation of the leg by lateral flaps / by Thomas Bryant.

  • Bryant, Thomas, 1828-1914.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Amputation at the knee-joint by disarticulation : with remarks on amputation of the leg by lateral flaps / by Thomas Bryant. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Yet, in spite of this advocacy, the operation is not fre- quently performed. By the majority of surgeons it is still regarded with suspicion. It is difficult to estimate how far this dislike of the operation is due to a want of experience of its advan- tages and how far to the groundless dread of leaving arti-. cular cartilage upon the bone, under the mistaken impres- sion that it will probably undergo degenerative changes, and so retard repair. I would also give, as an additional reason for the neglect of the operation, the personal liking which surgeons have recently shown for what I, for the sake of clearness, prefer to call the condyloid operation of Velpeau, or the supracondyloid amputation of Stokes. It is clear that the operations of Velpeau and Stokes, are applicable to cases of disease or destruction of the knee-joint itself, whereas the operation of amputation by disarticulation at the knee-joint can only be per- formed when the disease, or injury, for which the amputa- tion is practised is localised to the leg; when the condyles of the femur are unaffected or but slightly involved ; and when there is a sufficiency of healthy soft parts below the knee, from which good flaps can be made. With these conditions present, the operation of amputation by disar- ticulation should, for reasons to be given presently, be performed. I will now proceed to consider the value of the operation as shown from my own practice.