Orthopaedia or a practical treatise on the aberrations of the human form / by James Knight.
- Knight, James, 1810-1887
- Date:
- 1874
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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![muscles, the plantar aspect becomes convex, the internal malleolus and the scaphoid quite prominent, while the dorsum presents a complete depression of the arch. At this stage of the ailment, the patient suffers much pain in attempting to walk, and has but a very limited control over all efforts in that direction. TREATMENT OF EXTREME CASES OF TALIPES VALGUS. Cases that have advanced to an extraordinary degree of contortion have the following tendons shortened: The extensor longus and peronei will be found prominent and tense in front of the malleolus externus, and to facilitate the treatment should be severed before any effort at extension, by means of appa- ratus, is made; as the use of the latter without the former preparatory step will only encourage the patient to prolong the treatment by per- sisting in wearing the extension apparatus in hopes of a cure result- ing without submitting to tenotomy — an operation greatly dreaded. In most cases the tendo-Achillis will be found so tense as to like- wise require division. However, this may be deferred until after the section of the above mentioned tendons which in many cases, will be found all-sufficient for relief of the foot. The extension apparatus is that of the modified Scarpa shoe used in cases where there has been a shortening of the tendo-Achilles. The ankle joint, in the apparatus, being limited precisely as in the Fig 33 treatment of talipes varus; the only change being that of having the up- right spring applied to the inner side of the leg, tending the foot inward and sustaining it at a right angle with the leg, as well as permitting a free movement of the foot upward. [See Fig. 33, a varus shoe having the spring reversed.] A, the inner mar- gin of the foot; B, the metal sole plate ; C, the foot secured by the in- step pad and tapes.] This movement you should instruct the patient to perform by placing the front of the foot on some fixed object which would](https://iiif.wellcomecollection.org/image/b21135083_0083.jp2/full/800%2C/0/default.jpg)
