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Updated: June 4, 2025
At the proximal end there forms a bulbous swelling, which becomes adherent to the scar tissue. It consists of branching axis cylinders running in all directions, these having failed to reach the distal end because of the extent of the gap.
Whether it be torn loose from its point of attachment or ruptured at some point proximal thereto, the position is the same heel flat on the ground, toe slightly raised and this raising of the toe varies in degree as the subject moves about. The pathognomonic symptom is the lax tendon during weight bearing, which may be felt by palpation of the tendon along its course in the metacarpal region.
It is less successful than the proximal ligature, and is therefore restricted to aneurysms so situated as not to be amenable to other methods; for example, in aneurysm of the common carotid near its origin, the artery may be ligated near its bifurcation, or in aneurysm of the innominate artery, the carotid and subclavian arteries are tied at the seat of election. Compression.
The valves in the veins would seem to show conclusively that the venous current did not come from the heart, and surgeons must have observed thousands of times the every-day phenomenon of congested veins at the distal extremity of a limb around which a ligature or constriction of any kind had been placed, and the simultaneous depletion of the vessels at the proximal points above the ligature.
In the Negro, for instance, the stature is less than in the European. The cranium, as is well known, bears a small proportion to the face. Of the extremities the upper are proportionately longer, and there is, in both upper and lower, a less marked preponderance of the proximal over the distal segments.
While this weakens the wall of the vessel, it has the advantage of hastening coagulation, by bringing the blood into contact with damaged tissue. Whether the inner and middle coats are ruptured or not, blood coagulates both above and below the ligature, the proximal clot being longer and broader than that on the distal side.
A great difficulty is found in the fact that men are forever making generalizations that is, formulating laws too hastily. A few phenomena are observed and at once the hypothesis-constructing mind makes a guess as to the proximal causes of these phenomena.
The anterior portion of the capsular ligament forms sheaths for the extensor tendons, and both portions of the joint have an attachment around the distal end of the radius and another at the proximal end of the metacarpal bones. Etiology and Occurrence.
The ligature may be applied on the cardiac side of the aneurysm proximal ligation, or to the artery beyond distal ligation. Proximal Ligation.
It is essential that the ends should be sutured to each other, and as the proximal end is retracted the original wound may require to be enlarged in an upward direction. When primary suture has been omitted, or has failed in consequence of suppuration, the separated ends of the tendon become adherent to adjacent structures, and the function of the associated muscle is impaired or lost.
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