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100% found this document useful (7 votes)
57 views47 pages

Beginning AutoCAD 2006 1st Ed Edition Bob Mcfarlane - The Latest Ebook Is Available, Download It Today

The document provides information on downloading various AutoCAD-related ebooks, including 'Beginning AutoCAD 2006' by Bob McFarlane. It outlines the contents of the book, which covers essential 2D drafting skills, new features of AutoCAD 2006, and interactive exercises for users. Additionally, it includes links to other recommended AutoCAD and programming ebooks available for download.

Uploaded by

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Beginning AutoCAD 2006 1st ed Edition Bob Mcfarlane
Digital Instant Download
Author(s): Bob McFarlane
ISBN(s): 9780750669573, 0750669578
Edition: 1st ed
File Details: PDF, 13.07 MB
Year: 2006
Language: english
Beginning
AutoCAD 2006
This page intentionally left blank
Beginning
AutoCAD 2006
Bob McFarlane
MSc, BSc, ARCST
CEng, FIED, RCADDes
MIMechE, MIEE, MBCS, MCSD, FRSA

AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD


PARIS • SAN DIEGO • SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO
Newnes is an imprint of Elsevier
Newnes is an imprint of Elsevier
Linacre House, Jordan Hill, Oxford OX2 8DP, UK
30 Corporate Drive, Suite 400, Burlington, MA 01803, USA

First edition 2006

Copyright © 2006, Bob McFarlane. Published by Elsevier Ltd. All rights reserved

The right of Bob McFarlane to be identified as the author of this work has been
asserted in accordance with the Copyright, Designs and Patents Act 1988

No part of this publication may be reproduced, stored in a retrieval system


or transmitted in any form or by any means electronic, mechanical, photocopying,
recording or otherwise without the prior written permission of the publisher

Permissions may be sought directly from Elsevier's Science & Technology Rights
Department in Oxford, UK: phone (⫹44) (0) 1865 843830; fax (⫹44) (0) 1865 853333;
email: [email protected]. Alternatively you can submit your request online by
visiting the Elsevier website at http://elsevier.com/locate/permissions, and selecting
Obtaining permission to use Elsevier material

Notice
No responsibility is assumed by the publisher for any injury and/or damage to persons
or property as a matter of products liability, negligence or otherwise, or from any use
or operation of any methods, products, instructions or ideas contained in the material
herein. Because of rapid advances in the medical sciences, in particular, independent
verification of diagnoses and drug dosages should be made

British Library Cataloguing in Publication Data


A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data


A catalog record for this book is available from the Library of Congress

ISBN-13: 978-0-75-066957-3
ISBN-10: 0-75-066957-8

For information on all Newnes publications


visit our website at http://books.elsevier.com

Typeset by Charon Tec Ltd, Chennai, India


www.charontec.com
Printed and bound in Great Britain

06 07 08 09 10 10 9 8 7 6 5 4 3 2 1
Contents
Preface vii

Acknowledgements ix

Chapter 1 Using the book 1

Chapter 2 The AutoCAD 2006 graphics screen 2

Chapter 3 Drawing and erasing objects and using the selection set 13

Chapter 4 The 2D drawing aids 21

Chapter 5 Saving and opening drawings 29

Chapter 6 Standard sheet 1 34

Chapter 7 Line and circle object creation 38

Chapter 8 Object snap 48

Chapter 9 Creating arcs, donuts, ellipses, points and polygons 54

Chapter 10 Layers 62

Chapter 11 Creating a working drawing 78

Chapter 12 Using the Modify commands 1 80

Chapter 13 Text 90

Chapter 14 Dimensioning 113

Chapter 15 The MODIFY commands 2 129

Chapter 16 Grips 139

Chapter 17 Viewing drawings 146

Chapter 18 Hatching 152

Chapter 19 Drawing assistance and information 165

Chapter 20 Polylines 175

Chapter 21 Additional draw and modify commands 187

Chapter 22 The array command 194

Chapter 23 Changing object properties 201


vi Contents

Chapter 24 Text tables 210

Chapter 25 Tolerances 217

Chapter 26 Using various units and paper sizes 225

Chapter 27 Multilines, complex lines and groups 231

Chapter 28 Blocks and attributes 241

Chapter 29 Wblocks and external references 261

Chapter 30 Dynamic blocks 271

Chapter 31 The Design Center 281

Chapter 32 Pictorial drawings 292

Chapter 33 Model and paper space 300

Chapter 34 Templates, standards and sheets 309

Chapter 35 Toolbars and tool palettes 323

Chapter 36 File formats 329

Activities 335

Index 361
Preface
AutoCAD 2006 incorporates several new features which will increase user draughting
skills and improve productivity. Some of these new features are:

Create
1 Command enhancement of several common commands including:
a) join segments
b) create rectangles by area and angle of rotation
c) copy option with rotate and scale.
2 Dimension enhancement:
a) arc length dimension
b) jogged radius dimension
c) fixed length extension lines
d) different linetypes for dimension and extension lines
e) ability to flip the dimension arrow.
3 Hatching enhancement:
a) editing hatch boundaries
b) calculation of hatch area
c) creation of several hatch areas as separate objects
d) ability to specify the hatch origin
e) recreate a hatch boundary.
4 Multiline text enhancements:
a) in-place editor
b) bullets and numbering.

Manage
1 Customise the interface:
a) create and save user-defined workspaces
b) manage customised user-interface elements
c) toggle drawing aids with override keys.
2 General enhancements:
a) easier process of creating schedules and bill-of-materials with attribute extraction
b) scale list manager for viewports, page layouts and plotting.
3 Interface improvements:
a) Locking of toolbar and palette positions.

Produce
1 Dynamic blocks:
a) blocks defined with custom properties
b) part of blocks can be moved, rotated and stretched
c) visibility parameter for blocks
d) block look-up table.
viii Preface

2 Dynamic input:
a) commands entered via a tooltip
b) co-ordinate data displayed as cursor moved
c) co-ordinate entry ‘tied’ to dimensions
d) selection preview to highlight objects.
3 General enhancements:
a) Simple formulae can be inserted into tables for calculations.
4 New tools:
a) mathematical and trigonometric calculations possible
b) retrieval of back-up files.
5 Undo/Redo operations
a) Possible to undo/redo zoom and pan operations in a single action.

Share
1 Plot and publish tools:
a) Publish a 3D DWF.
Many of these new features will be discussed in this book.
Note the following:
1 This book is intended for:
a) new users to AutoCAD who have access to AutoCAD 2006
b) experienced AutoCAD users wanting to upgrade their skills from previous releases
c) readers who are studying for a formal CAD qualification at City and Guilds, BTEC
or SQA level
d) training centres offering CAD topics
e) undergraduates and post-graduate students at higher institutions who require
AutoCAD draughting skills
f) industrial CAD users who require both a text book and a reference source.
2 The objective of this book is to introduce the reader to the essential basic 2D draught-
ing skills required by every AutoCAD user, whether at the introductory, intermediate
or advanced level. Once these basic skills have been ‘mastered’, the user can progress
to the more ‘demanding’ topics such as 3D modelling, customisation and AutoLISP
programming.
3 As with all my AutoCAD books, the reader will learn by completing worked exam-
ples, and further draughting experience will be obtained by completing the additional
activities which complement many of the chapters. All drawing material has been
completed using Release 2006 and all work has been checked to ensure there are no
errors.
4 Your comments and suggestions for work to be included in any future publications
would be greatly appreciated.

Bob McFarlane
Acknowledgements
It would not have been possible for me to complete the various exercises and activities in
this book without the inspiration from all other AutoCAD authors. It is very difficult to
conceive new ideas with CAD and I am very grateful for the ideas from these other
authors. A special mention must be given to Dennis Maguire and his book ‘Engineering
Drawing from First Principles using AutoCAD’ published by Arnold.
This page intentionally left blank
Chapter 1
Using the book

The aim of this book is to assist the reader to use AutoCAD 2006 with a series of inter-
active exercises. These exercises will be backed up with activities, thus allowing the
reader to ‘practice the new skills’ being demonstrated. While no previous CAD know-
ledge is required, it would be useful if the reader knew how to use:
a) the mouse to select items from the screen
b) Windows concepts, e.g. maximise/minimise screens.

Concepts for using this book


There are several simple concepts with which the reader should become familiar, and
these are:
1 Menu selection will be in bold type, e.g. Draw.
2 A menu sequence will be in bold type, e.g. Draw-Circle-3 Points.
3 User keyboard entry will also be highlighted in bold type, e.g.:
a) co-ordinate entry: 125,36; @100,50; @200<45
b) command entry: LINE; MOVE; ERASE
c) response to a prompt: 15.
4 Icon selection will be in bold type, e.g. select the LINE icon from the Draw toolbar.
5 The AutoCAD 2006 prompt text will be displayed in typewriter face, e.g.:
a) prompt Specify first point
b) prompt Specify second point of displacement.
6 The symbol <R> or <RETURN> will be used to signify pressing the RETURN or ENTER
key. Pressing the mouse right button will also give the <RETURN> effect – called right
click.
7 The term pick is continually used with AutoCAD, and refers to the selection of a line,
circle, text item, dimension, etc. The mouse left button is used to pick an object –
called left click.
8 Keyboard entry can be LINE or line. Both are acceptable.

Saving drawings
All work should be saved for recall at some later time, and drawings can be saved:
a) to a formatted medium (zip disc, CD, memory stick, etc.)
b) in a named folder on the hard drive.
It is the user’s preference as to which method is used, but for convenience purposes
only I will assume that a named folder is being used. This folder is named MYCAD
and when a drawing is being saved or opened, the terminology used will be:
a) save drawing as MYCAD\WORKDRG
b) open drawing MYCAD\EXER1.
Chapter 2
The AutoCAD 2006
graphics screen

In this chapter, we will investigate the graphics screen and the user-interface. We will
also discuss some of the basic AutoCAD terminology.

Starting AutoCAD 2006


1 AutoCAD 2006 is started:
a) from the Windows ‘Start screen’ with a double left-click on the AutoCAD 2006 icon
b) by selecting the windows taskbar sequence:
Start-Programs-AutoCAD 2006-AutoCAD 2006 (or similar).
2 Both methods will briefly display the AutoCAD 2006 logo and then:
either a) the actual graphics screen
or b) the Startup dialogue box.
3 If the Startup dialogue box is displayed, then select Cancel at present. This will allow
the user access to the graphics screen. We will discuss the Startup dialogue box later in
this chapter.

The graphics screen


Figure 2.1 displays the basic AutoCAD 2006 graphics screen. Your screen may differ
slightly, but the general layout will be the same. The numbered items are:
1 The AutoCAD title bar 13 The on-screen cursor
2 The graphic screen menu bar 14 The Drawing area
3 The Standard toolbar 15 Scroll bars at right and bottom of
4 The Layer information toolbar drawing area
5 The Properties toolbar 16 The Object Snap toolbar (floating)
6 The Text Styles toolbar 17 The Sheet Set Manager palette
7 The standard ‘windows buttons’ 18 The Tool palette
8 The Windows taskbar 19 The Workspaces toolbar (floating)
9 The Status bar 20 The Draw toolbar (docked)
10 The Layout tabs 21 The Modify toolbar (docked)
11 The Command prompt window area 22 The Grips/Pickfirst boxes
12 The Co-ordinate system icon

Title bar
The title bar is positioned at the top of the screen and displays the AutoCAD 2006
icon, the AutoCAD Release version and the current drawing name.
The AutoCAD 2006 graphics screen 3

Figure 2.1 The AutoCAD 2006 graphics screen.

Menu bar
1 The screen menu bar displays the default AutoCAD menu headings. By moving the
mouse into the menu bar area, the cursor cross-hairs change to a pick arrow and with
a left-click on any heading, the relevant ‘pull-down’ menu will be displayed. The full
menu bar headings are:
File Edit View Insert Format Tools Draw Dimension Modify Window Help
2 Menu bar notes:
a) Pull-down menu items with ‘…’ after their name result in a dialogue box being
displayed when the item is selected, i.e. left-clicked.
b) Pull-down menu items with 䉴 after their name result in a further menu being
displayed when the item is selected. This is termed a cascade menu effect.
c) Menu items in BOLD type are available for selection.
d) Menu items in GREY type are not available for selection.
e) Menu bar and pull-down menu items are selected (picked) with a mouse left-click.
f) Pull-down menus are often called ‘drop-down’ menus.

The Standard toolbar


The Standard toolbar is normally positioned below the screen menu bar and allows
the user access to several button icon selections including New, Open, Save, Print, etc.
By moving the cursor pick arrow onto an icon and ‘leaving it for about a second’, the
icon name will be displayed in yellow (default). The Standard toolbar can be pos-
itioned anywhere on the screen or ‘turned off’ if required by the user. It is recom-
mended that the Standard toolbar be displayed at all times and positioned below the
screen menu bar (as the default).
4 Beginning AutoCAD 2006

Layer, Properties and Styles toolbars


These are normally positioned below and to the side of the Standard toolbar. Icon
selections are:
a) Layers: Layer Properties Manager, Layer Control, Make Object’s Layer Current,
Layer Previous.
b) Properties: Color Control, Linetype Control, Lineweight Control.
c) Styles: Text Style Control, Dimension Style Control, Table Style Control.

The Windows buttons


The Windows buttons are positioned at the right of the title bar, and are:
a) left button: minimise screen
b) centre button: maximise screen
c) right button: close current application.

The Windows taskbar


1 This is situated at the bottom of the screen and displays:
a) the Windows ‘Start button’ and icon
b) the name of any application which has been opened, e.g. AutoCAD
c) the time and the sound control icons
d) other icons/information dependant on user requirements.
2 By left-clicking on ‘Start’, the user has access to the other Programs which can be run
‘on top of AutoCAD’, i.e. multi-tasking.

The Status bar


Positioned above the Windows taskbar, the status bar gives the user:
a) on-screen cursor X, Y and Z co-ordinates information at the left
b) access to the drawing aid buttons, e.g. SNAP, GRID, ORTHO, POLAR, OSNAP,
OTRACK, DYN, LWT
c) access to the MODEL/PAPER space toggle.

Layout tabs
Allows the user to ‘toggle’ between model and paper space for drawing layouts. The
layout tabs will be discussed in a later chapter.

Command prompt window area


1 The command prompt area is where the user ‘communicates’ with AutoCAD 2006 to
enter:
a) a command, e.g. LINE, COPY, ARRAY
b) co-ordinate data, e.g. 120,150; @15<30
c) a specific value, e.g. a radius of 25.
2 The command prompt area is also used by AutoCAD to supply the user with informa-
tion, which could be:
a) a prompt, e.g. Specify first point
b) a message, e.g. object does not intersect an edge.
3 The command area can be increased in size by ‘dragging’ the bottom edge of the
drawing area upwards. I recommend a 2 or 3 line command area display.
4 The command prompt area can be toggled on/off with a CTRL and 9 key press.
The AutoCAD 2006 graphics screen 5

The co-ordinate system icon


This is the X–Y icon at the lower left corner of the drawing area. This icon gives infor-
mation about the co-ordinate system in use. The default setting is the traditional
Cartesian system with the origin (0,0) at the lower left corner of the drawing area.
The co-ordinate icon display can be altered by the user.

The cursor cross-hairs


Used to indicate the on-screen position, and movement of the pointing device will
result in the co-ordinates in the status bar changing. The ‘size’ of the on-screen cursor
can be increased or decreased to suit user preference and will be discussed later.

The drawing area


This is the user’s drawing sheet and can be any size required. In general we will use
A3-sized paper, but will also investigate very large and very small drawing paper sizes.

Scroll bars
Positioned at the right and bottom of the drawing area and are used to scroll the
drawing area. They are very useful for larger sized drawings and can be ‘turned-off’ if
they are not required.

Toolbars
By default, AutoCAD 2006 displays the Draw and Modify toolbars although users
may have them positioned differently from that shown in Figure 2.1. Other toolbars
may also be displayed, and Figure 2.1 displays the Object Snap and Workspaces tool-
bars. Toolbars will be discussed later in this chapter.

Tool palettes
AutoCAD 2006 displays the Sheet Set Manager and all palettes by default. The user’s
screen may not display any tool palettes. Palettes can be cancelled, minimised or repos-
itioned by the user at any time.

The Grips/Pickfirst box


The user may have a small square box ‘attached’ to the cursor cross-hairs. This box
may be the Grips and/or the Pickfirst box, both aids to the user.

Terminology
AutoCAD 2006 terminology is basically the same as previous releases, and the follow-
ing gives a brief description of the items commonly encountered by new users to
AutoCAD.

Menu
1 A menu is a list of options from which the user selects (picks) the one required for a
particular task.
2 Picking a menu item is achieved by moving the mouse over the required item and
left-clicking.
3 There are different types of menus, e.g. pull-down, cascade, screen, toolbar button icon.
6 Beginning AutoCAD 2006

Command
1 A command is an AutoCAD function used to perform some task. This may be to draw
a line, rotate a shape or modify an item of text. Commands can be activated by:
a) selection from a menu
b) selecting the appropriate icon from a toolbar button
c) entering the command from the keyboard at the command line
d) entering the command abbreviation
e) using the Alt key as previously described.
2 Only the first three options will be used in this book.

Objects
Everything drawn in AutoCAD 2006 is termed an object (or entity) e.g. lines, circles,
text, dimensions, hatching, etc. are all objects. The user ‘picks’ the appropriate
entity/object with a mouse left-click when prompted.

Default setting
All AutoCAD releases have certain values and settings which have been ‘preset’,
these being essential for certain operations. Default values are displayed with <>
brackets, but the actual value can be altered by the user as and when required. For
example:
1 From the menu bar select Draw-Polygon and:
prompt _polygon Enter number of sides<4>
respond press the ESC key to cancel the command.
2 Notes
a) <4> is the default value for the number of sides
b) _polygon is the active command.
3 At the command line enter LTSCALE <R> and:
prompt Enter new linetype scale factor<1.0000> (or other value)
enter 0.5 <R>.
4 Notes
a) <1.0000> is the LTSCALE default value on my system
b) we have altered the LTSCALE value to 0.5.

The escape (Esc) key


This is used to cancel any command at any time. It is very useful, especially when the
user is ‘lost in a command’. Pressing the Esc key will cancel any command and return
the command prompt line.

Icon
An icon is a menu item in the form of a picture contained on a button within a named
toolbar. Icons will be used extensively referred to throughout the book.

Cascade menu
A cascade menu is obtained when an item in a pull-down menu with 䉴 after it’s name
is selected.
1 From the menu bar select the sequence Draw-Circle and the cascade effect as Figure
2.2(a) will be displayed.
The AutoCAD 2006 graphics screen 7

Figure 2.2 (a) Cascade menu and (b) a shortcut menu.

2 Cancel the cascade effect by:


a) moving the pick arrow to any part of the screen and left-clicking
b) pressing the Esc key – cancels the ‘last’ cascade menu, so two escapes are required.

Shortcut menu
1 A shortcut menu allows quick access to commands that are relevant to the current
activity.
2 Shortcut menus are displayed with a right-click:
a) within the drawing area with or without any objects selected
b) within the drawing area during a command
c) within the text and command windows
d) within areas and on icons in Design Center
e) on a toolbar, tool palette, model or layout tabs
f ) on the status bar or the status bar buttons.
3 Shortcut menus typically include options to:
a) repeat the last command entered
b) cancel the current command
c) display a list of recent user input
d) cut, copy, and paste from the Clipboard
e) select a different command option
f ) undo the last command entered.
4 Figure 2.2(b) displays a typical shortcut menu.

Dialogue boxes
A dialogue box is always displayed when an item with ‘…’ after it’s name is selected.
1 Select the menu bar sequence Format-Units and:
prompt Drawing Units dialogue box as Figure 2.3
respond select Cancel to ‘remove’ the dialogue box from the screen.
8 Beginning AutoCAD 2006

Figure 2.3 The Drawing Units dialogue box.

2 Dialogue boxes allow the user to:


a) alter parameter values
b) toggle an aid ON/OFF
c) select an option from a list.
3 Most dialogue boxes display the options OK, Cancel and Help which are used as follows:
OK: accept the values in the current dialogue box
Cancel: cancel the dialogue box without any alterations
Help: gives further information in Windows format. The Windows effect can be
cancelled with File-Exit or using the Windows Close button from the title
bar (the right-most button).

Toolbars
1 Toolbars are aids for the user. They allow the AutoCAD 2006 commands to be displayed
on the screen in button icon form. The required command is activated by picking (left-
click) the appropriate button. The icon command is displayed as a tooltip in yellow (the
default colour) by moving the pick arrow onto an icon and leaving it for a second.
2 There are 30 toolbars available for selection. The toolbars normally displayed by
default when AutoCAD 2006 is started are Standard, Layers, Properties, Styles, Modify
and Draw.
3 Toolbars can be:
a) displayed and positioned anywhere in the drawing area
b) customised to the user preference.
4 To activate a toolbar, right-click any displayed toolbar and:
prompt toolbar shortcut menu – Figure 2.4(a)
with a) list of all available toolbars
b) active toolbars indicated with a 冪
respond pick any toolbar name
and 1 toolbar displayed in drawing area
2 shortcut menu cancelled.
5 When toolbars are positioned in the drawing area as the Object Snap toolbar they are
called FLOATING toolbars.
The AutoCAD 2006 graphics screen 9

Figure 2.4 (a) The toolbar shortcut menu and (b) the Insert Block Fly-out menu.

6 Toolbars can be:


a) Moved to a suitable position on the screen by the user. This is achieved by moving the
pick arrow into the blue title area of the toolbar and holding down the mouse left but-
ton. Move the toolbar to the required position on the screen and release the left button.
b) Altered in shape by ‘dragging’ the toolbar edges sideways or downwards.
c) Cancelled at any time by picking the ‘Cancel box’ at the right of the toolbar title bar.
7 It is the user’s preference as to what toolbars are displayed at any one time. In general
I always display the Draw, Modify and Object Snap toolbars and activate others as and
when required.
8 Toolbars can be DOCKED at the edges of the drawing area by moving them to the
required screen edge. The toolbar will be automatically docked when the edge is reached.
Discovering Diverse Content Through
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Fig. 709

Teale’s method of amputation.

Bruns devised a method which is begun almost as an exsection, by an


oblique circular incision, with liberating lateral incisions, and division of all the
tissues over the inner border of the tibia and the outer side of the fibula; after
which, without disturbing skin attachments in front, the periosteum is
separated from the bones as high as the liberating lateral incisions permit, and
then the fibula first and later the tibia divided. It is practically a subperiosteal
excision of the leg bones and affords a well-protected stump. In effect it is an
anteroposterior flap method.
—It was Brinton who, in 1872, suggested the preservation of the semilunar
cartilages in all knee disarticulations, as in this way all the normal relations are
preserved and retraction is prevented. But the makers of prosthetic apparatus
have urged to abandon all true disarticulations, and to substitute for them the
Fig. 710 The Knee.supracondyloid
method, which
affords ideal stumps.
Disarticulations are supposed
to produce less shock, less
loss of blood, and less danger
of sepsis from opening up the
bone-marrow, while muscle
insertions are less disturbed
and the stump covering usually
is mobile and not very
Stump after Stephen Smith’s amputation at knee.
sensitive. No disarticulation
should be thought of unless the
joint involved be free from disease and unless about it there be met sufficient
healthy integument to furnish a satisfactory flap.
For a true disarticulation Stephen Smith’s bilateral method is now almost
universally adopted. Here the incision is begun one inch below the tubercle of
the tibia and is carried directly down to the bone, downward and forward
around the side of the leg, and then inward and upward toward the middle of
the popliteal space, the lateral flaps thus made being nearly duplicates. The
flaps thus cut out are completely separated from the bone up to the joint level,
where the ligaments are divided, the joint being manipulated as may be
necessary to best expose them and facilitate division. In this operation the
patella is usually removed, the joint being opened by separating its ligament at
its insertion into this bone. One should remember that the internal condyle is
lower and longer than the external, and that the internal flap should be
perhaps made on this account a little the longer of the two. Fig. 710 illustrates
the stump resulting from this operation and shows the cicatrix drawn up out of
harm’s way and resting in the fossa between the condyles. Fig. 711 illustrates
the simple method by lateral flaps.
Fig. 711

Amputation at knee by lateral flap. (Erichsen.)

Amputation of the Thigh.—Under this head, rather than that of amputation


at the knee, should be described the
supracondyloid amputations which give decidedly the best results of all, and
which are preferable to any others for the middle of the lower extremity. Of
these the best is that suggested by Gritti, which consists in not only removing
the condyles but sawing off the articular surface of the patella, which is then
drawn upward and applied to the end of the femur, the division of the latter
being made at a point above the condyles, where the diameter of both bones
will nearly correspond, this latter perhaps being a suggestion of Stokes rather
than of Gritti, who did not divide the bone quite so high. (See Fig. 712.)

Fig. 712

Gritti’s osteoplastic supracondyloid knee amputation, patella utilized: a, shaded parts are
those brought in apposition; b, appearance of Gritti stump after suture; c, correct apposition of
patella to femur; d, defective apposition. (Farabeuf.)

Fig. 712 will best illustrate the intent of the method as well as its
performance. The incisions are planned much as in the Stephen Smith
disarticulation method, only they are placed higher, and the patellar tendon is
divided as low down as possible, or even separated from the tibia, in order
that it may be made of use in attaching the divided patellar surface to the
femoral end. The rest of the operation is performed as by other methods, the
attachment of the patella being effected by tendon sutures, or, if necessary, by
an ivory peg, or even a metal tack or nail which may be left in place.
The beauty of this method is that the anterior surface of the patella is
preserved with its natural weight-bearing facilities and the bursa between it
and the skin, while the latter is undisturbed. On the end of this stump as much
weight can be steadily borne as when one ordinarily kneels, and to it a most
serviceable kind of artificial limb can be attached, with which one may walk as
though nothing had ever happened.
Another osteoplastic method, namely, that of Sabanejeff, is illustrated in
Figs. 713 and 714. In this instance the bone covering over the end of the
femur is taken from the upper end of the tibia, the patella not being disturbed.
It permits a lower division of the femur and the formation of a stump which is
of practically the same length as the original thigh.

Fig. 713 Fig. 714

Sabanejeff’s knee amputation. (Chalot.) Stump made as in Fig. 713. (Chalot.)

Amputation of the Thigh above the Knee.—For removal of the thigh it is


well to preserve as much of its
length as possible, and yet not at the expense of all other considerations. A
thigh stump too short is likely to be pulled awkwardly upward by the psoas
muscle, and upon such a stump it is difficult to secure an artificial limb
tolerable of control against such action of this muscle. On this account, then,
thigh stumps should be long. So far as the method is concerned the circular,
or some modification thereof, gives the best results in the majority of
instances. It may easily be modified into one of the oblique methods, or
liberating incisions may be used whenever they will be of service. If it be
absolutely necessary to make the amputation high hemostasis can be secured
by the same methods that are used in hip-joint amputations. The dense and
strong fascia lata, which lies beneath the superficial fascia, should be divided
at the same level with the skin, since it serves admirably, when secured by a
separate set of sutures, to make a good covering for the ends of the muscles,
after these have been themselves carefully united by buried sutures. The
sciatic nerve should be especially sought, thoroughly stretched, and divided
high up. The vessels often evince a tendency to retract within Hunter’s canal;
it is not, however, difficult to separate the vastus internus from the adductor
longus, between which they lie, and in this way gain access to them. Even for
high work on the thigh one may, if necessary, do as some have done at the
hip, make a preliminary ligation of the femoral artery. This may be especially
serviceable as an emergency measure, or in special cases of tumors which
have attained large size, are placed high up and call for somewhat atypical
methods.
The Hip-joint.—Amputation here is essentially a disarticulation and
constitutes one of the usually formidable and serious
operations of major surgery. Although the joint itself is generally easily
reached there are many things to be considered in the performance of this
operation, of which the mere arthrotomy is by no means the most important.
Preparations being all made, the first consideration is the control of
hemorrhage, for which several methods have been suggested, but of which
but two or three are in general use. Such procedures as compression of the
abdominal aorta, either with the hand or by tourniquet, or of the common aorta
through the rectum, with a lever, as suggested by Davey, or with the hand, as
suggested by Woodbury, or the exposure of the common iliac, either within the
peritoneum as practised by McBurney, or externally, or exposing the common
femoral above Poupart’s ligament, are now adopted by very few surgeons.
Langenbeck used to be fond of preliminary ligation of the femoral where it is
most accessible in the groin, and this is probably the best of all of these
methods. But they have been all practically discarded since Wyeth introduced
the simple method of transfixing the limb with his pins (i. e., long mattress
needles or skewers made for the purpose), these serving to hold in place an
elastic cord or tourniquet (Fig. 715). This has been found to be a great
improvement on the suggestion of Senn, who excised the femoral head and
then compressed each half of the limb with a separate elastic band.

Fig. 715

Wyeth’s bloodless method: pins inserted and tube applied.

The directions for the use of Wyeth’s pins are simple. Here, as in other
cases, it may not be practicable to use the elastic bandage from the lower end
of the limb, but one may at least elevate the limb and thus coax the blood out
of it by gravity or by gentle manipulation. While it is still in this position one of
the long pins is introduced just below the anterosuperior spine and a trifle to
its inner side, and made to emerge on a level with and about three inches
from the point of its entrance. The other needle is inserted just to the inner
side of the saphenous opening, and below the level of the crotch, and brought
out about one inch below the tuberosity of the ischium. Corks should then be
placed upon them so as to protect the needle points. Next a piece of elastic
tubing or band is placed around the limb above these pins and tightened, each
turn being made a little tighter, so as to absolutely control the circulation. The
effect of this is felt upon practically every vessel in that part of the body, and if
the method be properly practised it affords absolute security.
The surgeon now has his choice of various methods of disarticulation, either
that by anteroposterior flaps or lateral flaps, or by the circular, with the free
liberating lateral incision; or he may devise any method of his own which will
best meet the indication in a given case. Fig. 715 illustrates the employment of
Wyeth’s pins and the first circular incision made as for the circular method. Of
these all the latter seems preferable when circumstances permit. It should be
combined with a sufficient lateral incision, which should be made to pass well
over the great trochanter. The cuff raised through this incision should extend
down to the deep fascia and up to the level of the lesser trochanter, at which
level the deeper tissues are divided transversely or by a circular cut.
It is well next to lay down the knife and secure the large vessels, after which
the deep muscles are separated from the upper end of the shaft and the
proximity of the joint, while the entire limb may be still used as a lever in so
stretching the joint capsule as to better expose and divide it. So soon as the
capsule has been opened, and the entrance of air thus permitted, it will be
easy to expose and divide the teres ligament, after which the balance of the
disarticulation is easily effected. The large nerve trunks are now sought,
retracted, and divided high up, all visible vessels are secured firmly, after
which the elastic constriction may be gradually released and any vessels that
spurt may still be secured. There will nearly always be troublesome oozing
from the cut ends of the large muscles, and here, if hot water prove insufficient
to check it, with large curved needles and catgut sutures the muscle ends may
be secured by ligature en masse, before they are brought together for the
purpose of closing the stump.
Whatever the method selected as perfect a closure of the wound as
possible should be made, with ample provision for drainage. By careful deep
suturing, with tiers of buried sutures, it is possible to avoid leaving dead
spaces at any point except perhaps the acetabulum. Through retaining
sutures may also be used to advantage. It is most desirable to so plan the
incisions and the closure of the wound as to keep them, so far as possible,
away from the region of the perineum. Therefore the longer the inner flap or
inside of the stump the better. As conditions which necessitate removal of the
limb at the hip-joint are always serious, and have each their own peculiarities,
any method which will best serve the purpose should be used.
Plates LIX and LX, designed by Prof. Matas, afford the best and briefest
epitome of the choicest amputation methods which can be furnished.

THE STUMP.
An amputation having been effected, and the stump closed, there is still
occasion to consider how it may best be treated to fit it for its future purposes.
When entire chapters, or even small monographs, can be written on the
subject of “diseases of stumps” it would appear that the consideration is not
one of merely trifling import.
A good stump has a regular outline, with a protected scar, and should be
firm, yet mobile, and without tender or sensitive surfaces. It should constitute
the lower end of a truncated cone, and needs to be of sufficient length to
permit leverage within the socket of the artificial limb which will be fitted about
it.
A stump failing in these characteristics is a bad stump, the features which
especially tend to make it bad being undue conicity (Fig. 716) or sensitiveness
of surfaces, ulceration from friction, or, worse yet, occurring without it, and
neuralgia from inclusion of nerve ends, or from bone ends which present
osteophytic outgrowths and thus distort and displace tissues (Fig. 717). Acute
osteomyelitis occurs in stumps, as do slower carious processes which may
call for re-amputation, perhaps even at a distance. The stump is for a long
time more or less tender and troublesome, and its owner may be a sufferer
from hyperesthesia or perverted sensations.
The possibility of the production of a conical stump in children as the result
of atrophic elongation was mentioned early in this chapter. While this cannot
always be prevented it may sometimes be foreseen, and one should be
prepared at any time in such cases to circumcise the bone, forcibly retract the
tissues, and then divide the bone ends on a higher level.
PLATE LIX
The Right Lower Limb, Internal Lateral View (Surface
Incisions).

1, 2. Circular for middle and upper thirds of thigh.


3. Circular for lower third of thigh, showing tendency of circle to incline downward on
adductor side to compensate for greater retraction.
4. Incision for Gritti’s or Carden’s amputations at knee (single anterior flap).
5, 6. Stephen Smith’s bilateral flaps (posterior racquet).
7. Antero-posterior flaps, cut solid to the bone, the soft parts being elevated from the
periosteum (Marc See, von Brun’s method). This is the author’s preferred method for leg
only, simplified by making a simple circular with two lateral liberating incisions on fibular and
tibial sides.
8, 9, 10. Circular with posterior racquet extension to form bilateral flaps (Stephen Smith).
11. Guyon’s supra-malleolar amputation.
12. Lines of Syme’s amputation.
13. Inner aspect of Roux’s tibio-tarsal amputation; also subastragaloid.
14. Medio-tarsal amputation (inner aspect).
15. Tarso-metatarsal disarticulation (inner aspect).
16. Disarticulation of toe with its metatarsal.
17. Disarticulation of big toe; in front of this lines for amputating first or terminal phalanx
by long plantar flap.
PLATE LX
Surface Outlines of Amputations Practised in the Lower
Extremity.

1. Low circular with external incision (Furneaux Jordan) or at a higher level (gluteo-
femoral furrow) applicable to Wyeth’s method of disarticulating hip.
2. Circular incision with tendency to racquet posteriorly in middle third amputations.
3. Circular with posterior vertical incision in amputation of lower third of thigh.
4. Long anterior flap for supra-condyloid amputation of thigh.
5. Racquet incision with long anterior flap for extreme upper third of leg. Note long
posterior tail, which facilitates upward retraction of a solid musculo-cutaneous flap cut down
to the periosteum, resembling a bilateral flap operation (Stephen Smith). The same incision
cut a little higher is most serviceable in disarticulating at the knee.
6. Long-hooded anterior flap, with posterior racquet (Stephen Smith and Bier’s
osteoplastic).
7. Amputation by equal antero-posterior flap (Marc See, von Bruns).
8. Amputation by long anterior and short posterior flaps (Teale’s principle).
9. Amputation of leg at extreme lower third, practically a circular amputation converted
into a solid antero-posterior flap by liberating incisions on fibular and tibial sides.
10. Guyon’s supra-malleolar amputation of leg.
11. Medio-tarsal and intra-tarsal amputations (Chopart and its derivatives).
12. Tarso-metatarsal amputation (Lisfranc and derivatives).

An exquisitely neuralgic stump is usually made so by the entanglement of


nerve ends and their subsequent enlargement into so-called amputation
stump neuromas (which are histologically fibromas), from pressure upon
nerve terminals. Under these circumstances their excision through incisions
planned for the purpose, or the exsection of a portion of the nerve trunk at a
higher level, may be necessitated (Fig. 717).
Fig. 716 Fig. 717

Extreme case of conical stump. Neuromatous endings of nerves in a stump.

Fig. 718 Fig. 719

Ideal stump. Bad stump, because posterior flap was cut too
short, and there has been great retraction of
all soft tissues. (Farabeuf.)
While patients may prefer disuse of a stump for as long a time as possible
the judicious surgeon will prepare it as rapidly as he may for early application
of the expected artificial limb. Inasmuch as leg stumps allowed to hang
downward become cyanotic and edematous it is well to keep them bandaged,
and the makers of artificial limbs prefer to have the bandages kept wet. When
the stump is healed, passive motion of the remainder of the limb should be
begun, in order that there may be a minimum of stiffening of joints. If, then,
such a stump be bathed, massaged, moved, and then bandaged with
comfortable snugness with cold, wet bandages, over which oiled silk may be
fastened, and if this be done at least once each day, the stump will be
prepared for the artificial limb, on the average, in two to three months. One
should not wait for this expiration of time if it be thoroughly healed; or, on the
other hand, he may have to wait much longer under unfortunate
circumstances; but the above general principles of treatment and general
statements will be found to prevail. Figs. 718 and 719 illustrate the difference
between good and bad stumps, while Plates LIX and LX (reproduced from
Matas) furnish the surface outlines for selection of the various amputations of
the lower limb.

CINEPLASTIC OR CINEMATIC AMPUTATIONS OF THE UPPER


EXTREMITY.
The most pronounced and illustrative of recent methods is perhaps the
“cinematic” or “cineplastic” procedure of Vanghetti. This Italian surgeon
proposed a prosthetic method, in 1898, which is illustrated in Figs. 720, 721
and 722. He has shown that tendon terminations may be left exposed in
stumps, under favorable conditions, and so utilized as to serve remarkably
useful purposes—though under exceptional conditions. For a description of
these methods the reader is referred to his monograph. (G. Vanghetti, Plastica
e Protesi Cinematiche, Empoli, 1906.)
Fig. 720 Fig. 721
Fig. 722

Results of Vanghetti’s “cinematic” method, with preservation and utilization of tendons.


INDEX.

A
Abdomen, diseases of, diagnosis of, 768
distention of, in appendicitis, 856
drainage of, 776
general considerations and conditions of, 767
inflation of, 769
inspection of, 768
measurement of, 769
operation on, technique of, 773
palpation of, 768
bimanual, 769
wounds of, gunshot, 214, 232
Abdominal aorta, aneurysm of, 346
ligation of, 356
cavity, irrigation of, 775
diseases, diagnosis of, 768
incisions, closure of, 777
operations, after-treatment of, 777
embolism following, 784
hemorrhage after, 780
peritonitis following, 780
technique of, 773
thrombosis following, 784
viscera, general considerations and conditions of, 767
wall, abscess of, 783
actinomycosis of, 783
burns of, 783
carcinoma of, 784
contusions of, 781
cysts of, congenital, 783
endothelioma of, 784
epithelioma of, 784
erysipelas of, 783
fibroma of, 784
foreign bodies in, 783
gangrenous cellulitis of, 783
hematoma of, 781
injuries of, 781
lacerations of, 781
osteomyelitis of, 783
phlegmons of, 783
sarcoma of, 784
suppurative spondylitis of, 783
syphilis of, 783
tuberculosis of, 783
tumors of, 783
vascular, 784
wounds of, gunshot, 783
penetrating, 781
Abscess of abdomen, 783
atheromatous, 73, 339
bone, 419, 425
treatment of, 426
of brain, 567
prognosis of, 569
symptoms of, 568
treatment of, 573
of breast, 757
classification of, 58
acute, 58
cold, 58, 112
gravitation, 58
metastatic, 59
subacute, 58
subfacial, 59
subperiosteal, 59
cold, 112
peri-articular, treatment of, 399
collar-button, 319
definition of, 58
frontal, 569
of heart wall, 733
ischiorectal, 879, 1013
of liver, 911
symptoms of, 912
treatment of, 912
lumbar, 114
of lung, 734
of mesentery, 939
metastatic, 59, 91
occipital, 569
of pancreas, 949
parietal, 569
peri-appendicular, 860
perilaryngeal, 704
perineal, 1013
treatment of, 1013
perinephritic, 961
perirectal, 879
treatment of, 879
peritracheal, 704
perityphlitic, 860
of prostate, 994
psoas, 114
of rectum, 879
treatment of, 879
renal, 957
retropharyngeal, 114, 682
signs of, 60
of spleen, 941
subphrenic, 753
treatment of, 754
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