. Operative surgery. Fig. 686.—Fowlers operation. Formationof flaps and buttonholes. Fig. 687.—Fowlers operation. Flapspassed through buttonholes. place the flaps with the skin surfaces facing each other, rotate each flapslightly, and pass them through the buttonhole so as to project a quarter ofan inch or more on the palmar surface. The extremity is pinned to thepalm as no sutures are needed. At the end of a week divide the web, anda healthy integumentary tissue will be found to occupy the cleft. If adouble web be present, each flap can be thrust through the slit correspond-ing to it. The wou
. Operative surgery. Fig. 686.—Fowlers operation. Formationof flaps and buttonholes. Fig. 687.—Fowlers operation. Flapspassed through buttonholes. place the flaps with the skin surfaces facing each other, rotate each flapslightly, and pass them through the buttonhole so as to project a quarter ofan inch or more on the palmar surface. The extremity is pinned to thepalm as no sutures are needed. At the end of a week divide the web, anda healthy integumentary tissue will be found to occupy the cleft. If adouble web be present, each flap can be thrust through the slit correspond-ing to it. The wound on the dorsum (Fig. 687) is closed at once and DEFORMITIES. 567. AngersC. Cot- dressed; the bases of the flaps arc divided when the weh is severed. Thewound is treated aseptically tlirougliout. The Remarks.—When the joints of tlic digits are fused, it is not wise, asa rule, to attempt their separation, since, though it may be accomplished,the digits when separated may have their function greatly impaired; how-ever, this course of action is not so objectionable sincethe advent of asepsis. If a supernumerary digit pos-sesses an independent articulation, it can be removedwithout any great danger to its associate. Ingrown Toe Nail.—Ingrown toe nail is quite a com-mon affliction, to the relief of which various palliativemeasures have been directed (Fig. 688). As a rule,however, they have been found inadequate to effecta cure. This condition is induced largely by improp-erly fitting boots and shoes, although in some personsthere exist additional causes. Going barefooted will ina majority of cases effect a cure, but, since this is rarelypracticable, o
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