WOUNDS 223 
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antiseptic solution, the patient cast and chloroformed, and 
the operation proceeded with. 
An Esmarch’s bandage should be first applied, and a 
tourniquet afterwards placed higher up on the limb. The 
foot is then secured as described in an earlier chapter, and 
the whole of the horny structures of the lower surface of 
the foot (the sole, the frog, and the bars) pared until quite 
near the sensitive structures, or, if under-run with pus, 
stripped off entirely. An incision is then made in each 
lateral lacuna of the frog, the two meeting at the frog’s 
point. Each incision thus made should be carried deep 
enough to cut through the substance of the plantar cushion. 
A tape is then passed through the point of the frog, tied in 
a loop, and given to an assistant to draw backwards. The 
plantar cushion itself is then incised in a direction from 
Fie. 106.—‘ Curerrs,’ on Votkmann’s Spoon. 
before backwards, and pulled on by the assistant, so as to 
expose the plantar aponeurosis. 
Should this be found at all necrotic, it may be taken that 
purulent inflammation of the navicular bursa and of the 
navicular bone itself exists. The operator must then pro- 
ceed to resection of the tendon in order to treat the deeper 
structures thus affected. At its point of insertion into the 
semilunar crest the tendon is severed and afterwards re- 
flected. This exposes the inferior face of the navicular 
bone. Instead of the glistening and clear appearance it 
ordinarily presents, its glenoid cartilage is found to be 
showing hemorrhagic or even purulent spots of necrosis. 
The terminal portion of the tendon must then be excised. 
To effect this a clean transverse incision is made at the 
extreme upper border of the navicular bone. Here we are 
in close contact with the pedal articulation, and great care 
