. Operative surgery. All osteotomies should be performed under strict antiseptic pre-cautions, and the incision of the soft parts closed with a catgut limb must be immovably fixed and the patient kept quiet; in fact,the measures applicable to a compound fracture are in order, since oste-otomy resembles that condition more nearly than any other. The Results.âThe results of all osteotomies performed with antisepticprecautions are extremely satisfactory. As yet, I have no personal knowl-edge of a death from the operation, and of fourteen hundred osteotomiesbut about one per cent only a
. Operative surgery. All osteotomies should be performed under strict antiseptic pre-cautions, and the incision of the soft parts closed with a catgut limb must be immovably fixed and the patient kept quiet; in fact,the measures applicable to a compound fracture are in order, since oste-otomy resembles that condition more nearly than any other. The Results.âThe results of all osteotomies performed with antisepticprecautions are extremely satisfactory. As yet, I have no personal knowl-edge of a death from the operation, and of fourteen hundred osteotomiesbut about one per cent only are reported to have died in consequence of it. Hallux Valgus.âHallux valgus is practically limited to the great toe,and is usually caused by improperly fitted boots and shoes. Fig. 471 (Tubby)represents the condition more graphically than words can. In this con-dition the first phalanx (anatomical) articulates with the outer portion ofthe distal extremity of its metatarsal bone and is rotated inward on its long. Fig. 471.âHallux OPERATIONS ON BONES. 447 axis. The principal portion of the head of the metatarsal hone projects in-ward, and its extremity is surmounted hy a sensitive hunion. The indicationis to place the toe in its normal axis and retain it in that position. In pro-nounced cases this can not be accomplished without division at the least ofrestraining fibrous tissues. If the deformity be great, little else than anoperation on the bone will be of any practical value. Two methods of oper-ation can be recommended: 1. The removal of the head of the metatarsal bone, together with enoughof the shaft to permit the great toe to be easily replaced and held in its normalaxis (Fig. -1:23, a). Under strict antiseptic precautions this operation resultsin quick recoveries and useful toes. 3. The deformity can be corrected by removing a A^-shaped piece (cunei-form osteotomy) from the inner portion of the distal extremity of the meta-tarsal bone, as near the head as possible with
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