Fig. 297.—Disarticulation of the claw and third phalanx.
It is better, in such cases, to remove the claw or the two last phalanges. With antiseptic precautions the stump heals, and recovery takes place without the interminable suppuration and pain which otherwise cause such grave loss of condition.
(1.) Disarticulation of the Claw and Third Phalanx.—The patient is cast and suitably fixed. The horn-secreting coronary band of the claw must be preserved.
First stage. The horny wall immediately beneath the coronary band is thoroughly thinned and the tissues are divided as far as the bone.
Second stage. Disarticulation: The tendon of the extensor pedis is divided and the joint opened. The claw is pressed backwards, and first the external and internal ligaments, then the flexor tendons of the phalanges, are divided.
Fig. 298.—Amputation of the two last phalanges. First and second phases.
Fig. 299.—Amputation of the two last phalanges. Third phase.