A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . of the articula-tion ; or may, in some patients, be the start-Fig. 75. ing-point of erysipelas or gangrene. The preventive treatment of bunion consists inmaintaining the correct axis of the toe andrestoring it when deflection first occurs. Thefirst is to be done by avoiding continuousstanding during youth and wearing shoeswith flat heels and broad soles, and almoststraight along the inner edge. The trueWaukenphast pattern fulfil
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . of the articula-tion ; or may, in some patients, be the start-Fig. 75. ing-point of erysipelas or gangrene. The preventive treatment of bunion consists inmaintaining the correct axis of the toe andrestoring it when deflection first occurs. Thefirst is to be done by avoiding continuousstanding during youth and wearing shoeswith flat heels and broad soles, and almoststraight along the inner edge. The trueWaukenphast pattern fulfils these a metal support worn inside the shoeso as to maintain the tarsal arch on the innerside of the sole, may be beneficial in thosewith a tendency to flat foot and in young orweak persons compelled to stand a great of a distorted toe may be accom-plished by steel springs and elastic traction,so arranged as to be worn constantly. Tenot-omy of muscles which act as displacing causes,division of the ligaments, excision of the joint or amputation of the toemay be justifiable if the deformity and the resulting inflammation and. Biggs apparatus for replacing toein chronic subluxation. BUNION. 197 necrosis cause great disability. The bursitis must be managed by rest,elevation of the foot, anodyne lotions, painting with nitrate of silveror tincture of iodine and the local and general measures required ininflammation. The formation of pus requires an incision, but in alloperations in this region in old and debilitated patients it must be re-membered that the circulation here is feeble and sepsis treatment of bunion, then, is identical with that of inflamed bursseelsewhere. A radical cure can sometimes be effected by introducing a tenotomeat a distance and cutting up the bursal sac, as is occasionally done inthecal cysts. Laying open the sac by a free incision or excising itmay at times be justifiable. CHAPTER XIV. DISEASES AND INJURIE
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