Improved method of treating club-foot / by Alex. Ogston.

  • Ogston, Alexander, 1844-1929.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Improved method of treating club-foot / by Alex. Ogston. 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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    the foot being by degrees overcome, it unfolds from its perverse position, and has not the same strong tendency as formerly to spring back again. After as much advance has been made as seems prudent, the hands are removed, and the foot, if the manipu- lation has been well managed, lies passive and improved in pos- ture, flaccid, and with considerably diminished tendency to return to its old vicious shape. There are no marks of its having suffered from the proceeding; there are no signs of fracture, contusion, or even abrasion, but the foot appears simply more normal in shape. When this has been achieved the operator next proceeds to fix it with plaster of Paris in its new posture. It is bandaged from the roots of the toes to the insertion of the ligamentum patellae with a single thickness of flannel bandage, one and a half inches in breadth and four feet long. To retain the foot in the position most nearly approaching that of the normal foot, two strips of adhesive lead plaster are used, each of them eighteen inches long by one-third of an inch broad. One of these is made into a loop, applied to the foot over the ball of the great toe, and, guided by the hand of an assistant, pulls the foot outwards, or rather retains it by moderate traction in the favourable posture gained by the manipulation already described (see Figure 1). The second strip is likewise made into a loop, passed round the foot over the ankle and heel at the exact spot that seems most adantageous in each case, and forms a resist- ing force to the traction exercised by the former loop, by drawing the ankle inwards, or rather preventing its being drawn outwards. The assistant who holds these two stands on the right side of the pelvis of the patient with his face to the child’s feet, and uses the toe strap with his right and the ankle strap with his left hand. In this manner he avoids interference with the. operator, who now proceeds to put on the plaster bandages. A strip of “ book muslin,” one and three-quarter inches broad and five feet long, with plaster of Paris well rubbed into its meshes and loosely rolled up, is dipped for a few seconds into water until it is well soaked, then wrung firmly to expel the superfluous water, and wound round the foot and leg, beginning at the toes. It should not be drawn tight, but simply laid on outside the flannel band- age and loops of strapping where the latter are in contact with the limb, and it should be brought once or twice between the limbs of the straps where they leave the foot to proceed to the hands of the assistant holding them. The toes should be left un- covered. After the plaster bandage is in position, about a heaped breakfast-cupful of dry plaster of Paris is made into thin, nearly fluid, paste by adding the required quantity of water and stirring with a spoon, a common iron kitchen spoon serving this purpose best. With the spoon the paste is spread on the foot and leg, first along their upper surfaces, then along their sides, and finally