The surgical diseases of children . be firmly secured overthe wound, the foot being also bandaged from the toesupwards. Digital pressure might be employed ifnecessary, and no attempt should be made at flexingthe foot for about a week. The foot should be keptwarm and quiet. At the lime of the accident noheroic measure need be contemplated. As regards the failure of union between the cutends of the tendon (a contingency of the rarest occur-rence), the surfaces may be vivified and approximated 486 The Surgical Diseases of Children. in the extended position of the foot by the use of afew catgut su
The surgical diseases of children . be firmly secured overthe wound, the foot being also bandaged from the toesupwards. Digital pressure might be employed ifnecessary, and no attempt should be made at flexingthe foot for about a week. The foot should be keptwarm and quiet. At the lime of the accident noheroic measure need be contemplated. As regards the failure of union between the cutends of the tendon (a contingency of the rarest occur-rence), the surfaces may be vivified and approximated 486 The Surgical Diseases of Children. in the extended position of the foot by the use of afew catgut sutures, the wound being treated withantiseptic precautions. When the union is secure theheel may be brought gradually down either with orwithout a fresh tenotomy. (See page 490.) Intractable inversion of the foot may ulti-mately demand a section of the tendons of the tibialisposticus and the flexor longus digitorum, or possiblyof that of the tibialis anticus, the spots at which theirdivision should be effected being indicated in the. st Fig. 82.—Tendons at AnHe. The dots indicate where tenotomy mayconveniently be performed. adjoining figure, copied from Brodhursts work onorthopaedic surgery. There may be a difficulty in a chubby child infinding the tendon of the posterior tibial muscle : itis at a spot midway between the anterior and posteriorborders of the leg, a little above the malleolus. Thepoint of the knife first finds the tibial shaft, and then,passing on the flat behind the bone, and in front ofthe tendon, has its edge turned towards the tendon,which it divides together with the tendon of the longflexor of the toes. If any salient band be detected atthe time of operation it should be divided. So, also,with any tarsal ligaments which may be felt to keepthe foot from being placed and retained in the im-proved position. The anterior part of the internal lateral ligamentof the ankle may require subcutaneous section, as may chap, Treatment of Club Foot. 487 also oth
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
