Orthopaedia or a practical treatise on the aberrations of the human form / by James Knight.

  • Knight, James, 1810-1887
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Orthopaedia or a practical treatise on the aberrations of the human form / by James Knight. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    * 72 (JRTHOPjEDTA. and that it reaches only to the breadth of the tendon to be divided; by this precaution, the anterior tibial artery can be avoided. Arteries and nerves are but seldom wounded when proper pre- caution is taken ; first, to apply resisting force to the tense tendon, rendering it more prominent, then placing the forefinger of one hand upon the tendon and carefully inserting the knife beneath, limiting the cutting edge to the breadth of the tendon. This pre- caution will apply to the severing of nearly all tense tendons. There is an exception, circumstantial, however, in the case of section of the biceps tendon when shortened at the knee. The perineal nerve has been severed from indiscretion or want of practical knowledge. In cases of long standing, the nerve is shortened as well as the tendon, and cannot be avoided, even when the tendon is cautiously severed; but from the shortened condition of the nerve also, it presents a tense margin, and the operator, supposing that he has not severed the entire tendon, again inserts the knife and severs the nerve. The result of this is a paralysis of the pero- neus and extensor muscles, terminating in talipes equino-varus. The first stage of valgus is readily relieved by a steel spring hav- ing an elevation to correspond with the normal width of the foot, and secured in the shoe at the heel by two or three screws; the anterior portion left free to glide upon the inner sole of the shoe. The spring is constructed of thin sheet steel, and the arch raised with the hammer. The form, when cut Fig.32. out of sheet steel, is as represented in Fig- / /^->N This spring should be worn for eighteen months or two years. This has been our common treatment for over twenty years, and when carefully persevered in, has never failed to cure valgus in the incipient stage and even in advanced conditions — sometimes where other treatment had been objected to, as the spring can be worn in the ordinary shoe. If in the first stage of valgus, the tendency is not arrested, greater exaggeration ensues; the bearing of the foot inclines to the anterior and inner edge, the heel in some cases being elevated outward from a shortening of the gastrocnemius and soleus No. 1 is the form when cut out of the sheet of steel, and No. 2 represents the arch, 3 showing the outer edge, which has been drawn into form by the raising of the arch 2. No. 1. No. 2.
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