. The surgical treatment of the common deformities of children . d other plans have abandoned them for thesupra condylar one. I may say, however, thatfrom the point of abstract mechanical rectification,separation and displacement upwards of the internalcondyle as devised and practised formerly by Og-ston, and then by MacEwen (see Fig. 32), mustresult in a far more perfect shaping of the limb 110 CHILDRENS DEFORMITIES. Mac Ewensoperation. than any section across the whole hone can operation indeed is a very attractive one,but the risks involved by its proximity to, or in-volvemen
. The surgical treatment of the common deformities of children . d other plans have abandoned them for thesupra condylar one. I may say, however, thatfrom the point of abstract mechanical rectification,separation and displacement upwards of the internalcondyle as devised and practised formerly by Og-ston, and then by MacEwen (see Fig. 32), mustresult in a far more perfect shaping of the limb 110 CHILDRENS DEFORMITIES. Mac Ewensoperation. than any section across the whole hone can operation indeed is a very attractive one,but the risks involved by its proximity to, or in-volvement of the knee joint, has led to its fallingout of favour, as compared with some form ofMacEwens, which, although not mechanicallyfaultless, does in practice result in the productionof a very straight and useful limb. The operation, as described by MacEwen, is per-formed with a chisel, of the pattern before described,and a mallet. The bone is divided from the innerside, the skin incision being a longitudinal one,about an inch above the condyles, as shown in the. Fig. ?}?>.—Femur, etc, showing MacEwens and Ogstons imisions. illustration, where also Ogstons incision is chisel is introduced with its edge in the longaxis of the limb, and when against the bone it isturned round at right angles to it. The application GENU VALGUM. Ill of an Esmarchs bandage has been advised, but Ibelieve that it is rather hurtful than limb must be well steadied on a sand-bag, andthe bone should be at least two-thirds cut throughbefore the division is completed by fracture. Withthis internal incision great care must be taken lestthe chisel should slip, when it might injure thepopliteal vessels. Such a disaster has been knownto occur, and there appear to be no sufficientlycogent reasons for operating from the inner side asMacEwen recommended, to counterbalance thegreater safety of making an external incision in asimilar way and place, and chiselling throughfrom without. But
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