Lectures on orthopedic surgery . r strength and muscular de-velopment are the natural result of use when once thedeformities have been corrected. Clubfoot has no effectupon the general health and does not endanger life. The treatment of clubfoot is mechanical, or operative,or both mechanical and operative. The earliest recordthat we have is that of the treatment employed by Hip-pocrates and consisted of bandaging and the use of aleaden shoe. The first mechanical device intended to have a posi-tive corrective action of which we have record is the shoe of Scarpa, of Pavia, in 1803, from which al
Lectures on orthopedic surgery . r strength and muscular de-velopment are the natural result of use when once thedeformities have been corrected. Clubfoot has no effectupon the general health and does not endanger life. The treatment of clubfoot is mechanical, or operative,or both mechanical and operative. The earliest recordthat we have is that of the treatment employed by Hip-pocrates and consisted of bandaging and the use of aleaden shoe. The first mechanical device intended to have a posi-tive corrective action of which we have record is the shoe of Scarpa, of Pavia, in 1803, from which all 309 later shoes and braces for the treatment of this deformityare hardly more than modifications. The aim of allbandaging and brace treatment is to maintain the footin a somewhat corrected position, and to gradually gainsomething upon this position by the exercise of somuch of a corrective force as can be borne withoutserious discomfort or injury to the soft parts. Braces,bandaging, and the various retentive dressings are us6d. Fig. 246.—Hand stretching of eqiiinovarus during infancy. either alone or in conjunction with various operativeprocedures. The simplest and most frequently used of the reten-tive dressings is the plaster-of-paris bandage. Plaster-of-paris was first used in these cases by Jules Guerin, ofParis, in 1826. He braced the foot in the best positionpossible and poured liquid plaster around it. Theplaster bandage is of much more recent date. It is 310 used as a retentive dressing after hand-stretching andwrenching, and after any of the cutting operations tobe mentioned hereafter. Narrow bandages from two tothree inches wide are the best. They may be applieddirectly over the well greased foot, or over the footwrapped with cotton or with bandages made from sheet-wadding. The most convenient covering, however, is asmoothly fitting stocking. The plaster bandage shouldbe wrapped from within under the foot and outward sothat at each turn the foot is drawn somewhat
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