Bone operations for the correction of club-foot : based upon an analysis of 435 operations by 108 operators / by H. Augustus Wilson.

Wilson, H. Augustus (Harry Augustus), 1853-1919.

Date:: 1893

Credit: Bone operations for the correction of club-foot : based upon an analysis of 435 operations by 108 operators / 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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$completely subluxated. Fob. 24,1891, Phelps’ operation (three tenotomioB of tendo Achilhs had been done previously). Perfect restoration of foot. 38 Dr Daniel La Forte. Harper Hospital Bulletin, 1891. ii. p. p. 39. Patient 6 years of age. Equino-varus, double congenital, severe. Nov. 9, 1889, excision of cuboid and section of tendo Achillis; .Tan. 20, 1890, tendo Achillis again cut. Treatment continued several months; lery good results. ' Tenotomy twice without success. 039 Dr Le Bee. France Medicale, 1889. Patient 13 years of age. Equino-varus. March 22, 1888 excision of astragalus and scaphoid with section of tendo Achillis, tibialis anticus, and plantar fascia Good union by first intention. Nine months later walks well, leg shorter, foot flat on the ground. Braces. Ankle-joint motion. Astragalus and scaphoid were ankylosed. 240 Same operator (not published). Patient 14 years of age. Equino-varus, right. Oct. 20,1888, excision of astragalus and scaphoid. Two months later walks well, foot straight and flat. Braces. Ankle-joint motion limited. 241. Same operator Same patient. Equino-varus, left. Oct. 20, 1888, excision of astragalus and scaphoid. Suppuration for four weeks. Two monthB later walks well, foot straight and flat. Braces. Ankle.joint motion limited. 242. Same operator. Paris Thesis, 1889-90. H. Le Marc’hardam. Patient, female. Excision of astragalus and scaphoid, and section of tendo Achillis, tibialis anticus, and plantar fascia. Good result. 243. Dr. Le Dente. Paris Thesis (cites Bull, de la Soc. do Chirurg.). Patient 30 years of age. Equino-varus severe. Excision of astragalus, cuboid, ant. ext. angle of os calcis, and post. int. angle of scaphoid. Yery satisfactory result. 244. Same operator. Bull, et Mem. de la Soc. de Chir. de Paris, 1887, xiii. p. 728 (disc, on paper of Duret). Patient 7 years of age. Equino-varus. Excision of astragalus and cuboid and part of cal- caneum. Some ankle-joint motion. 245. Dr. Lenger. Ann. de la Soc. Med.-Chir. de Liege, 1890. xxix. pp. 165-66. Patient 11 years of age. Congenital varus, left, calcaneum elongated and its exterior surface curved inward ; the trochlea of astragalus almost entirely outside the tibio-fibular sheath, scaphoid against the inner malleolus. Jan. 15, 1890, excision of astragalus and ant. 2 cm. of calcaneum. Healed within a month. Perforated zinc splint applied over dressings until healing was complete. Articulation free, especi- ally after so extensive a bony resection. Dr. Lenger does not think that equino-varus can be arrested without extirpation of the astragalus. 246. Same operator aud reference. Same patient. Congenital varus, right. Feb. 5, 1890, excision of astragalus and ant. 2 cm. of calcaneum. Healed within a month. Perforated ziDC splint applied over dressings and healing was complete. Articulation free, especially after so extensive a bony resection. 247. Dr. Lucke. Patient, male, 15 years of age. Congenital varus, single. 1881, excision of astragalus. Good results. 248. Dr. Lund. Lancet, 1878, i. p. 349. Patient, male, 7 years of age. Equino-varus, left, severe. May 7, 1872, excision of astragalus. Wound healed by thirty-eighth day. Four months later walks comfortably with apparatus. Rectangular splint, elastic traction; on sixty-eighth day Barwell’s elastic ties applied. Slight ankle-joint motion. Tenotomy at six months ; apparatus failure. 249. Same operator. Paris Thesis, 1S89-90, H. Le Marc’hardam (cites Clntnod as above, see D (26) ante). Patient 29 years of age, Equino-varus, congenital. Removal of astragalus and section of aponeurosis plantaris and tib. ant. tendon. Result bad. Patient walked with a brace, but had pain in so doing. 250. 251. Same operator. Brit. Med. Journ., Oct., 1872. Patient, male, 7 years of age. Right and left equino-varus, congenital. Heels not on the ground. May 17th, excision of astragalus. Wound healed on thirty-eighth day. July 16th, Barwell’s system applied ; Sept. 30th, Sayre’s shoes applied; rectangular splints just after operation. August 1st, considerable ankle-joint motion. Tenotomy at six months; under treatment four mouths and wore apparatus until thirteen months old. Woro shoes nearly one month, and walks without help. 252. Dr. C. W. MacGillivray. Trans. Clin. Soc, London, and Edinburgh Med. Journ., 1SS4-85. Patient, male, 6 years of age. Equino-varus, left. Tendons aud fascia tense. Removal of cuboid os calcis, and ext. cuneiform; second operation in same place removed truncated wedge. Healed rapidly; perfect position after second operation ; boy walks with case on sole of foot in six weeks after. Foot shortened and tendo Achillis on inner side, though quito mobile at meso-t.nrsal articulation. Suitable splint. Internal displacement decidedly improved ; anterior part still points downward. 253, Dr. F. Margury (his obs. No. 2). Bull, et Mem. de la Soc. do Chir. de Paris, 1890 xvi p 89 Cites Margary, Sulla cura operativa del Pied Vara cougenito inveterato, Milan, 1884, Patient 14 years of age Equino-varus, double congenital, extreme. Curvature marked, contraction of plantar fascia tibml muscles and tendo Achillis, motion at ankle-joint limited, marked atrophy of muscles of calf! Jun. 15, 1884, excision of astragalus, scaphoid, cuboid, Bection of tendo Achillis and tibialis anticus and plantar fascia, superficial and deep, and removal of part of the skin on upper surface of foot. Healing rapid cicatrix, partly by first and partly by second intention. May 18, patient discharged n good condition ; ireo motion in leg, and foot altogether corrected of deformity. Braces. The re- sult noth as to lorm aud functionating power astonished Burgeons who examined it 254. Dr. Marzo Mnrzocchi. Archivlo di Ortopedia, Milan, 1892, vol. ix.p. 119. Patient 13 years y 1Jmllln[)TariU8’ r.5 l{* Muscles somewhat atrophied, but responded to volition and electricity, t o r’ 4* niGth°d ; later (date not given) excision of astragalus. Twentieth day, foot tends *i ' I V Rn< P08^100 °f astragalus called for another operation ; thirty days after second opera- motion'f< * °UrV0 movements of flexltm and extension ; allowed walking very easily. Ankle-joint$