The principles and practice of surgery: embracing minor and operative surgery : with a bibliographical index of American surgical writers from the year 1783 to 1860 : arranged for the use of students (Volume 2) . ES EQUINUS. 627 left at rest, the ordinary changes of subcutaneous wounds ensue, such as theeffusion of blood, the liquid portions of which are shortly absorbed, afterwhich there is an effusion of lymph, which, becoming organized, unites thetwo cut extremities of the tendon. This new tissue, when first formed, iselastic and extensible, and if at this period mechanical measures are app
The principles and practice of surgery: embracing minor and operative surgery : with a bibliographical index of American surgical writers from the year 1783 to 1860 : arranged for the use of students (Volume 2) . ES EQUINUS. 627 left at rest, the ordinary changes of subcutaneous wounds ensue, such as theeffusion of blood, the liquid portions of which are shortly absorbed, afterwhich there is an effusion of lymph, which, becoming organized, unites thetwo cut extremities of the tendon. This new tissue, when first formed, iselastic and extensible, and if at this period mechanical measures are applied,the heel may gradually be brought down, and the deformity overcome in afew days. But the rationale of this plan of treatment should never be lostsight of; for if the surgeon ignorantly brings the heel down, by mechanicalmeans, immediately after the division of the tendon, non-union may be theresult, or so much new structure maybe formed, that the increased length ofthe tendon will be greater than is desirable to restore the equipoise of thelimb, and the patient be lamed for life, being thus rendered unable to con-tract his gastrocnemius muscle sufficiently to raise the heel from the ground. Fig. View of a Foot after the Heel is brooght down in Pes Equinus. The surgeon should, therefore, delay about five days after the operationof tenotomy before mechanical means are employed, and only apply themvery gradually at first. If the heel be brought down one line a day, in lessthan two weeks it will have descended an inch. Gradual extension, there-fore, is amply sufficient, and it is only by such pressure and patient persever-ance that the cure can be accomplished. After the heel is thus brought to the ground, the patient, though well ableto walk, will generally present some deviation of the foot, if it is closely ex-amined, Fig. 443. g 1.—Phalangeal Variety of P#s Equinus. In connection with pes equinus, it is necessary to allude to what is calledthe Phalangeal variety of
Size: 1510px × 1654px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdec, booksubjectsurgicalproceduresoperative
