The surgical treatment of the diseases of infancy and childhood / by T. Holmes.
- Timothy Holmes
- Date:
- 1868
Licence: Public Domain Mark
Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.
544/700
![method of proceeding. The operation is clearly far more la- borious and difficult than that which I have described; but it is, I think, worthy of trial. Results of An exaggerated idea appears to prevail of the mutilation sion. of the foot necessarily produced by the operation which I have described; and M. Oilier seems to be under the influ- ence of this idea in dwelling on the superior results of his subperiosteal operation. I am therefore glad of an opportu- nity of bringing forward a representation of a foot in which I excised the os calcis a few months since, without any attempt to preserve the periosteum, though no doubt a good deal of it remained behind in the wound, as it commonly does. It is very probably in consequence of the variable extent of peri- osteum removed, that we meet with varieties in the amount of flattening of the foot. I do not think I ever saw so little flattening as in this case, which will certainly bear comparison with M. Ollier's, or with anything that could be produced by any other method whereby the disease could be removed. M. Oilier might perhaps reply, that his method will insure con- stantly what mine will only furnish occasionally and by [Fig. 81. Appearance of the foot a few months accident : but this is exactly after total excision of the os calcis, showing n• , ti the amount of flattening of the heel. The ^ matter 111 dispute. It point of commencement of the horizontal in- Jj^S yet to be shown that cision is seen.] , , i , « subperiosteal resection can be accomplished without so lacerating the periosteum that it will perish, unless the membrane adheres only loosely to the bone, when it will be separated by the dissecting operation. In other words, it has yet to be shown whether excision by the knife or by the raspatory is superior. For my own part, without pretending to dogmatise on the subject, my present exjierience has prejudiced me much in favour of the knife. Perforation Another method, aiming at the preservation of the foot, age-tube, is that so strongly recommended by M. Chassaignac, of pass-](https://iiif.wellcomecollection.org/image/b20416325_0544.jp2/full/800%2C/0/default.jpg)
