In general it may be said of the bones of the foot that one which resists reasonable effort at reduction, when displaced, should be removed. Various displacements of the tarsal bones, as the result of direct violence, may occur, as well as of the metatarsal and phalanges. Many of them may be reduced by judicious pressure and manipulation, but the violence which inflicts the displacement will frequently make the injury so compound that excision or partial amputation may be necessary.
PART VI.
SPECIAL OR REGIONAL SURGERY.
CHAPTER XXXVI.
INJURIES AND SURGICAL DISEASES OF THE HEAD.
THE SCALP.
ERYSIPELAS AND CELLULITIS.
Erysipelas and cellulitis of the scalp are the result of the same infections and conditions as when encountered in other regions, but are peculiarly prone to occur here because of the liability to infection from the hair with the material concealed in and upon the surface. They frequently lead to suppuration, in which case abscesses form that may extend inside the cranium, or into the frontal or other sinuses. These are common about the orbit and in the upper eyelid, and unless speedily incised may lead to gangrene. Multiple abscesses are also common. Disturbances of sight and hearing as sequels of these infections occasionally occur. The principal danger from these purulent collections pertains to intracranial infection or general sepsis, usually of pyemic type.
Fig. 366
Pneumatocele of cranium. (Warren’s Surg. Obs., 1867.)