1. Metal plates, wires, screws, nails; are objectionable and unreliable.
2. Silk ligatures the same.
3. Bone graft the same.
4 Arthrodesis. Excellent results in lateral instability, especially where there are good calf muscles. The best results are to be found after the triple arthrodesis of Ryerson or the sub-astragalar arthrodesis of Davis. Arthrodesis of the ankle joint is rarely indicated.
5. Astragalectomy with backward displacement of the foot, when done after the method of Royal Whitman, first for calcaneus, calcaneo valgus, etc.; second, for dangle feet, third for lateral deformity gives by far the best results. In some cases the result has been so perfect and the foot so symmetrical that it would have been difficult to tell that the foot had been operated on, had one not been able to see the scar.
6. Horizontal transverse tarsectomy, after the method of G. G. Davis, gives as a whole inferior results to the astragalectomy and is a more difficult, bloody and less surgical procedure.
7. Living ligaments, after the method of Gallie, Putti, Peckham and others, have given isolated successes, but as a general rule, have not been successful and are not held in universal esteem.
A great many of the fixation cases that were examined were done after the ordinary tendon transplantations had failed, and it would seem that the place for tendon transplantations is as an adjuvant to a 'stabilizing operation.'
(C) 1921 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.