A treatise on orthopedic surgery . f webbing. This aidsin fixing the heel. (See Figs. 568 and 569.) If efficient mechanical treatment is applied at the proper time—that is to say, in earliest infancy—no operation other thandivision of the tendo Achillis will be required. If the deformity is not corrected or is but partially corrected 838 OETEOPEDIC SUEGEBY. when the child begins to walk, some form of operation is, as arule, indicated; but division of the resistant tissues must alwaysbe combined with the employment of sufficient force to accom-plish the desired result, viz., overcorrection of t
A treatise on orthopedic surgery . f webbing. This aidsin fixing the heel. (See Figs. 568 and 569.) If efficient mechanical treatment is applied at the proper time—that is to say, in earliest infancy—no operation other thandivision of the tendo Achillis will be required. If the deformity is not corrected or is but partially corrected 838 OETEOPEDIC SUEGEBY. when the child begins to walk, some form of operation is, as arule, indicated; but division of the resistant tissues must alwaysbe combined with the employment of sufficient force to accom-plish the desired result, viz., overcorrection of the manual correction, applied in the manner described, isthe most efficient means of attaining this object. ISo instrumentcan equal the hand. The force that can be applied by the handis sufficient for the correction of all the ordinary cases in earlychildhood, and, in combination with subcutaneous division ofthe more resistant tendons and ligaments, even in later childhoodand adolescence. Fig. 568. Fig. Showing the progressive reduction of deformity and illustrating the processof changing the shape of the brace from time to time until it holds the foot invalgus. (See Fig. 565.) Astragalectomy and cuneiform osteotomy are never indicatedas primary operations, but one or the other or both maybe neces-sary for the complete rectification of the deformity when othermeans have failed. Forcible correction by the Thomas wrench under the sameconditions is an efficient treatment, and the instrument may be DEFORMITIES OF THE FOOT. 839 used to supplement manual correction in resistance cases, butthere is a manifest disadvantage in submitting a patient to asuccession of wrenchings as was the Thomas practice, if imme-diate overcorrection can be attained at one operation. The Phelps operation, v^hich combines thorough division ofthe resistant parts with the application of sufficient force to over-correct the foot, is the operation of selection for the more re-sista
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