A treatise on orthopedic surgery . ection of the deformity. Phelps operation is essentially simply the division of resistantparts through an incision on the inner border of the foot, com-bined with sufficient force, manual or instrumental, to overcor-rect the deformity. It is the most conservative of the moreradical procedures, and by it even the most severe type of de- ^ Wiener Klinik, November, December, Bradford and Lovett, 2d ed., p. 414. JDEFOEMITIES OF THE FOOT. 831 formity in the adult can be corrected; that is to say, the de-formity may be overcome and a serviceable foot may be
A treatise on orthopedic surgery . ection of the deformity. Phelps operation is essentially simply the division of resistantparts through an incision on the inner border of the foot, com-bined with sufficient force, manual or instrumental, to overcor-rect the deformity. It is the most conservative of the moreradical procedures, and by it even the most severe type of de- ^ Wiener Klinik, November, December, Bradford and Lovett, 2d ed., p. 414. JDEFOEMITIES OF THE FOOT. 831 formity in the adult can be corrected; that is to say, the de-formity may be overcome and a serviceable foot may be assuredto the patient. Perfect functional cure is not possible whendeformity has been confirmed by many years of neglect. The steps of the Phelps operation are as follows: Afterproper surgical preparation the Esmarch bandage is tendo Achillis and usually the posterior ligaments of theankle are divided subcutaneously, and by manual or instrumen-tal force one attempts to correct the plantar flexion. An incision Fig. The left foot (Fig. 557) corrected by Phelps operation and by cuneiform osteot-omy of the OS calcis. is then made on the inner border of the foot, just below and infront of the internal malleolus, which is extended directly down-ward over the head of the astragalus to include the inner quarterof the sole. Through the incision all resistant parts are dividedin order, as stated by Phelps. 1. The tibialis posticus, and the anticus if it offers re- sistance. 2. The abductor hallucis. 3. The plantar fascia. 832 0BTE0P2DIC SURGERY. 4. The flexor brevis digitorum, 5. flexor of the toes. 6. The deltoid ligament in all its branches. During the successive division of the tissues repeated attemptsare made to correct the foot, and only those structures aredivided that present themselves as tense and resistant tissueswhen the foot is forcibly abducted. In the adult type of club-foot no particular eftort is made torecognize the different structures, but a
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