. The surgical treatment of the common deformities of children . ty mayprove itself in later years, if neglected, in childhoodit will always yield to persistent treatment. [f all or several of the toes are affected, in placeof a single straight splint it will be necessary tofashion a digitated metal foot-plate, to which thetoes must be attached, whether or no the ligamentsor tendons have required division. The great toe is frequently deflected or twistedoutwards, displacing the other toes, or riding overor, more rarely, under them. This deformity isknown as Hallex Valgus ; it is much less comm
. The surgical treatment of the common deformities of children . ty mayprove itself in later years, if neglected, in childhoodit will always yield to persistent treatment. [f all or several of the toes are affected, in placeof a single straight splint it will be necessary tofashion a digitated metal foot-plate, to which thetoes must be attached, whether or no the ligamentsor tendons have required division. The great toe is frequently deflected or twistedoutwards, displacing the other toes, or riding overor, more rarely, under them. This deformity isknown as Hallex Valgus ; it is much less commonin children than in adults, and is not in them com-plicated by the l^resence of a bunion, as is frequentlythe case in grown-up people. Operative measures, such as excision of thejoint, or removal of a wedge from the metacarpalbone, as Barker recommends, are never calledfor in children, for these cases will always yieldto simple measures. Relief may be given byprotecting the prominent joint from pressure, by theadjustment of a horse-shoe pad of adhesive II illes V;ilgu> Mansof. Fig. 78.—Hallex Valgus. 190 CHILDRENS DEFORMITIES. and the malposition will generally yield to theaction of a wedge-shaped pad between the toes ; inmore severe cases, a splint such as is here figured{Fig. 78) ma} be worn, or the foot may be adjustedto a sole-plate as described by Neale. The appar-atus consists of a tin-plate cut to the naturalshape of the foot, notched to a cork sole, in whichslots are then cut in such places that the toes can beretained in their proper positions by tapes passedbetween them. In fast-growing children, especially in boys, acondition of irritability and swelling about themetacarpo-phalangeal joint of the great toe is notuncommon, and this may lead on to hallex valgus :its chief cause is the wearing of too short boots, amistake which is easily rectified when recognised. Simple hypertrophy, both of fingers and toes, butespecially of the great toe, is sometimes me
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