Fractures and dislocations / by T. Pickering Pick.

  • Thomas Pickering Pick
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Fractures and dislocations / by T. Pickering Pick. Source: Wellcome Collection.

    509/548 (page 497)
    posterior border rests somewhere near the summit of its trochlear surface, and the anterior border, advanced beyond its natuml position, overhangs, without actually being in contact with, the scaphoid bone. By some authors it is stated that these dislocations may take place without any fracture. Under these circumstances, the lateral ligaments on both sides must be torn, as well as the anterior ligament of the ankle joint. Generally, however, the fibula is fractured above the malleolus, and the lower end displaced backwards with the bones of the tarsus, and often the internal malleolus is also broken, being torn off from the rest of the bone in conse- quence of the gi-eat strength of the deltoid ligament, which pre- vents it giving way. Symptoms.— There is great deformity of the foot and a marked appearance of shortening. In front of the ankle joint is a hard, prominent, transverse ridge, which is con- tinued upwards into the leg as a marked elevation. The transverse ridge terminates in an abrupt mai-gin ; below and beneath it is a depression or sulcus, as if the skin were tucked in under the ridge. The toes are pointed downwards. Behind the joint is the pro- minence of the heel, which forms a marked projection, rendered the more distinct by a depression above it. The tendo Achilles is tense, and ]iresents a somewhat curved outline with the concavity backwards (Fig. 91). In the partial- dislocation the symptoms are Or G—17 Fig. 91.—Dislocation of the Bones of the Foot backwards. The figure represents the deformity whicli is produced by a dislocation of the bones of the tarsus backwards from the ankle joint.