At what age should the first treatment of congenital club-foot be instituted? / by H. Augustus Wilson.

  • Wilson, H. Augustus (Harry Augustus), 1853-1919.
Date:
1892
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Licence: Public Domain Mark

Credit: At what age should the first treatment of congenital club-foot be instituted? / by H. Augustus Wilson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    time to do tenotomy is when the child begins to walk, but advo- cates manipulation being instituted at birth. Professor Sayre1 says: “If prompt treatment were the rule, section of the tendons would rarely be called for, but should be resorted to when neces- sary.” Gross:2 “Age is no bar to tenotomy.” Druitt :3 * * “ The earlier tenotomy is done after other treatment fails, the better.” Ewens :* “No educated surgeon of the present day would, I imagine, allow an infant to reach the age of three months without tenotomizing every contracted tendon or putting on suitable apparatus; but it becomes a serious question how far one would be justified in allow- ing a child to grow up beyond the age of three years, when it is evident that the bony deformity is so great as to defy rectification by free tenotomy.” Bryant6 recommends manipulation and strap- ping a few days after birth, and tenotomy when necessary; has operated at one week. Stephen Smith :G “ Treatment as soon after birth as possible.” Wyeth:7 “All forms should be treated from birth, and tenotomy determined by degrees of resistance.” Moullin8 urges treatment to begin in infancy; tenotomy, if manipulation, etc., fail. Schrieber :9 “As early as possible.” Parker:10 “ It may be laid down as a canon that treatment should commence immedi- ately after birth, and that tenotomy is an essential feature of the treatment of many cases.” Pye:11 “I believe that it will be found much speedier and a more satisfactory plan to recognize from the first that early tenotomy will give the best results.” Bradford :12 “ Treatment should be begun as early in infancy as possible; the amount of time gained by tenotomy is not great.” Vance13 begins treatment about the tenth day by manipulation and retention 1 L. A. Sayre: Trans. 9th Internat. Congress. 2 S. D. Gross: System of Surg., ed. 1882, vol. ii. p. 1030. 3 Druitt: Modern Surg., ed. 1887, p.49l. I John Ewens: Brit. Med. Journ., Oct. 17, 1891. 6 Bryant: Prac. Surg., ed. 1884, p. 817. 6 Stephen Smith : Operative Surg., ed. 1887, p. 824. 7 Wyeth : Text-book on Surg., ed. 1890, p. 811. 8 Moullin: Treatise on Surg., ed. 1891, p. 355. 3 Schrieber: Woods’ Med. and Surg. Monographs, vol. ii., No. 3, p. 807. 70 Parker: Congen. Club-foot, ed. 1887, p. 85. II Pye; Surg. Treat. Common Deformities of Children. 1889. Bradford : “ Treat. Club-loot,” Trans. Amer. Orth. Asso., 1887, vol. i. p. 89. Vance: Discussion, Trans. Amer. Orth. Asso., 1889, vol. i. p. 115.
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