The Dynamic Stability of the Knee [Summary]

Operation: This is performed under ring block anmsthesia. A local tourniquet is applied. The nail is gently elevated and avulsed from side to side if this has not been done already to allow gross infection to subside. The infected granulations in the lateral nail folds are gently curetted away. Each fold is retracted and the deep lateral groove exposed. The distal pulp is pierced by a No. 1 sterile needle at a point so that it may be pushed accurately along the floor of the lateral nail groove. It is pushed home until it is arrested by the terminal phalanx. An incision is made round the eponychium from one needle to the other. Two further incisions extend from the proximal corners of the eponychium at 45 degrees. Dorsal and lateral skin flaps are reflected to give adequate exposure. Lateral incisions are made down to bone parallel and below the needles. A proximal transverse incision joins these and is placed proximal to the embedded needle points. It is a superficial marker since the extensor tendon may lie under it. The needles are withdrawn past the lunule and the rectangle of tissue