An operation for paralytic calcaneo-cavus / by Robert Jones.

  • Robert Jones
Date:
1915
Catalogue details

Licence: Public Domain Mark

Credit: An operation for paralytic calcaneo-cavus / by Robert Jones. Source: Wellcome Collection.

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    AN OPERATION FOR PARALYTIC CALCANEO-CAVUS. BY ROBERY JONES, F.R.C.S.E., LIVERFOOL, ENGLAND. Surgeon to the Royal Southern Hospital, and to the Royal Liverpool Country Hospital for Children. Lecturer on Clinical Surgery to Liverpool University. The literature of flail ankle is copious and conflicting, and that type known as paralytic pes calcaneo-cavus is, of all others, the most intractable to treat. It may involve complete paralysis of the calf muscles, or only partial, and be accompanied by paralysis of some or all the other muscle groups. The heel is depressed and often continues in the line of the tibia, the posterior aspect of the os calcis becoming the inferior, while the hollow foot is dependent upon the depres- sion of its anterior part at the midtarsal joint. (Fig. 5.) As the toe drops sometimes below the level of the heel, the general surgeon often commits the serious blunder of dividing the tendo Achillis and so cuts his only ally adrift. Mechanical treatment is woefully depressing, and I think the most serious attempt from the operative side has been made by Royal Whitman. Recognizing that from the upright position of the heel the body weight is erroneously deflected, he makes a long external incision from behind and above the external malleolus, below its extremity and terminating at the head of the astragalus. The peronei tendons are divided well forward and deflected ; the joint is opened and the foot displaced inwards. The astragalus is then enucleated. Sections of bone are removed from the outer surface of os calcis and cuboid. On the inner side the susten-
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