The immediate restoration of parts to the normal position after tenotomy / by Reginald H. Sayre.

  • Sayre, Reginald H.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: The immediate restoration of parts to the normal position after tenotomy / by Reginald H. Sayre. 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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    sanction of high authority, and although it has repeatedly effected cures in my own hands, I am, nevertheless, from experience, induced to give the preference to the method introduced chiefly by Pauli, of Landau, and Bouvier, of Paris. Instead of attempting to reunite the tendons, they bring the foot down at once as nearly as possible to its proper position. * * The objection urged against this plan of treatment, viz.: that there is danger, especially in old cases, of no ultimate reunion of the tendon, is utterly untenable, because ample experience has proven that this union invariably occurs, even when the extremities of the tendon are separated two or three inches. In my own practice I have repeatedly seen this take place. The great advantage which it possesses is in the saving of time; although there is less pain when the heel is depressed as far as possible immediately after the operation than when this is post- poned for two or three days. I am fully convinced that I might have cured several of my patients in one-half of the time employed had I pursued the former instead of the latter method.” The principle of immediate correction of the deformity has been applied with marked success to the treatment of deformity in the horse, as the following letter from Mr. J. Roalfe Cox, M. R.C. V. S., which forms the appendix to Mr. Adams’ Jacksonian prize essay on Club Foot will testify: “In 1861, the bay colt called ‘Suspicion,’ by Alarm, out of Blue Bell, had congenital deformity of one fore foot, due to insufficient length of the flexor perforans tendon. * * * The colt being at the time of my examination six months old, I found that he could only tread on the front of the hoof, the entire sole of the foot presenting backward and unable to touch the ground. The result at this period being that the front of the hoof was worn by contact with the ground, whilst there was preternatural depth of the hoof at the back part from continuing growth and absence of attrition (see cut). * * * The coit being valueless for training, or indeed service of any kind, tenotomy under my advice was determined on as the only possible recourse, and accordingly within a few days I performed the operation, under chloroform, by introducing a narrow blade between the two tendons, and dividing the inner one. The immediate result was a perfectly adjusted posi- tion of the limb, and a separation to the extent of two inches be- tween the cut ends of the tendon.