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By means of splints, the interphalangeal, metacarpo-phalangeal, and wrist joints should be gradually extended until the deformity is over-corrected (R.
There are predisposing causes that merit consideration, chief among which is the normal conformation of the coronet joint. This proclivity is constant; the normal interphalangeal articulation is an incomplete ginglymoid joint and while its dorso-volar diameter is great, this in no wise compensates for its disproportionately narrow transverse diameter.
Recovery does not take place until the dead bone is removed, and the usefulness of the finger is often seriously impaired by fibrous or bony ankylosis of the interphalangeal joints. This may render amputation advisable when a stiff finger is likely to interfere with the patient's occupation. Cellulitis of the forearm is usually a sequel to one of the deeper varieties of whitlow.
The absence of pain or inconvenience in many instances doubtless keeps the number of cases reported few, and again we must take into consideration the fact that the class of persons afflicted with ainhum are seldom brought in contact with medical men. The disease usually affects the 5th phalanx at the interphalangeal joint. Cases of the 4th and other phalanges have been reported.
Open navicular joint does not occur, as a rule, except by way of the solar surface of the foot, and the introduction of active and virulent contagium is certain to happen; consequently, an acute synovitis quickly resulting in an intensely septic and progressively destructive arthritis soon follows in perforation of the capsule of the distal interphalangeal articulation. Etiology and Occurrence.
A notch is then cut at each of the following positions: one notch about one inch from the butt end, a second opposite the middle of the upper arm, one opposite the elbow, one opposite the bend of the wrist, one at the first interphalangeal joint, one at the finger-tip.
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