. The principles and practice of surgery. es itstwo extremities with the first across thetop of the foot, as in Symes amputa-tion. The joint being opened in front,Line of section of the Bone. according to the method already de- scribed in the tibio-tarsal amputation,the upper portion of the calcaneum is exposed, when the saw is appliedobliquely to the calcaneum in front of the attachment of the tendo-Achillis, and the bone divided in such a manner that the section shallcorrespond to the incision upon the sole of the foot. The malleoli,with a thin section of the lower end of the tibia, are then

- Image ID: 2AFM8DG
. The principles and practice of surgery. es itstwo extremities with the first across thetop of the foot, as in Symes amputa-tion. The joint being opened in front,Line of section of the Bone. according to the method already de- scribed in the tibio-tarsal amputation,the upper portion of the calcaneum is exposed, when the saw is appliedobliquely to the calcaneum in front of the attachment of the tendo-Achillis, and the bone divided in such a manner that the section shallcorrespond to the incision upon the sole of the foot. The malleoli,with a thin section of the lower end of the tibia, are then
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Image ID: 2AFM8DG
. The principles and practice of surgery. es itstwo extremities with the first across thetop of the foot, as in Symes amputa-tion. The joint being opened in front,Line of section of the Bone. according to the method already de- scribed in the tibio-tarsal amputation,the upper portion of the calcaneum is exposed, when the saw is appliedobliquely to the calcaneum in front of the attachment of the tendo-Achillis, and the bone divided in such a manner that the section shallcorrespond to the incision upon the sole of the foot. The malleoli,with a thin section of the lower end of the tibia, are then removed, theflap containing the section of bone brought up, and united by suturesand straps. Results.—Necrosis of the divided calcaneum is an occasional, yetrare, result of this operation. The stump is usually firm and tolerantof pressure; and, as in Symes operation, the patients are often able towalk, and even run and leap, without the aid of an artificial foot. Mr.Hudson is of opinion, however, that the base of support is too low in. PIROGOFF S AMPUTATION. 3G9 PirogofPs operation to allow of the proper adaptation of an artificialfoot. In the accompanying wood-cut is seen the appearance of the Fig. 157.