The malformations, diseases and injuries of the fingers and toes and their surgical treatment . little chanceof the separated digits re-uniting ; and ProfessorLister informs me that the result of a case onwhich he operated after this manner has been mostsuccessful. The following method of performingthis operation will, I think, be found most con-venient. Introduce a trochar and canula (a No. 4 canulaanswers very well) through the web or union whichconnects the two digits, at a point where thecleft between these two organs would naturally thus made an opening completely throughthe web
The malformations, diseases and injuries of the fingers and toes and their surgical treatment . little chanceof the separated digits re-uniting ; and ProfessorLister informs me that the result of a case onwhich he operated after this manner has been mostsuccessful. The following method of performingthis operation will, I think, be found most con-venient. Introduce a trochar and canula (a No. 4 canulaanswers very well) through the web or union whichconnects the two digits, at a point where thecleft between these two organs would naturally thus made an opening completely throughthe web, the trochar is to be withdrawn, and apiece of Indian-rubber cord, about the thicknessof a No. 8 catheter, passed through the canula ;the canula may now be removed, leaving the cordin the wound ; one end of the cord is to be carriedalong the dorsum of the hand, and secured to a 58 CONGENITAL AFFECTIONS band passed round the wrist, the other end is tobe carried along the palm of the hand, and securedat the wrist in the same manner, as is illustratedby the diagram. The advantage of this plan. is that the cord being soft and elastic, allowsthe hand to move freely without disarranging theapparatus, while at the same time it also acts as anefficient foreign body. In cases where the union isnot quite so firm, I have divided the whole union OF THE DIGITS. 59 at once, separated the two layers of the skin atthe side of the connected digits, brought the edgesof these wounds together with sutures, and thenintroduced the elastic cord between the dividedfingers, adjusting it in the same way at the treatment prevents the wounds at the side ofthe fingers re-uniting, and keeps up a gentle pres-sure on the lower part of the cleft. Even in thismethod of operating, great care is required in con-ducting the after treatment. About nine monthsago I divided in this way a very firm union be-tween the ring and middle fingers of a child, fifteenmonths old. The wounds gradually healed, and in
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