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Reclaiming the maimed; a handbook of physical therapy . w. Slight adhesionsmay be broken down by these means, not only without in-jury, but with great relief to the joint, but any persistentpain after treatment warns the operator of the necessity forcaution. Circumduction of the ankle is done by the hand, but fullflexion is difficult or impossible when the powerful tendonAchilles is contracted, and a preliminary tenotomy is oftenindicated. The hold for this purpose is shown in Fig. 45. Flat foot and claw foot (pes cavus) are often treated forlong periods by massage and passive movement without
Reclaiming the maimed; a handbook of physical therapy . w. Slight adhesionsmay be broken down by these means, not only without in-jury, but with great relief to the joint, but any persistentpain after treatment warns the operator of the necessity forcaution. Circumduction of the ankle is done by the hand, but fullflexion is difficult or impossible when the powerful tendonAchilles is contracted, and a preliminary tenotomy is oftenindicated. The hold for this purpose is shown in Fig. 45. Flat foot and claw foot (pes cavus) are often treated forlong periods by massage and passive movement without re-sults. These procedures can have but a minor place in thetreatment of such conditions, and they should be referred RECLAIMING THE MAIMED 63 for surgical or orthopedic treatment by operation, support,and reeducation. Flexion and extension at the knee may be done by thehand, the patient being seated with the leg over the end of aplint for flexion, or lying prone on a plint for either extremeflexion or full extension. The hand is much better than any. Fig. 45. — The hold for flexion of the ankle and stretching thetendo Achillis. machine, because it can give the important rotation move-ment of the leg upon the thigh in flexion so wefl insisted uponby Sir Robert Jones. At the end of each complete flexion ofthe knee, twist it in and out. The hip can be extended, flexed, rotated, adducted, andabducted, with the patient supine on a plint, the ankle ofthe side to be moved being grasped by the operator by onehand, his other hand placed on the knee of the same leg, andthe other knee drawn up to a right angle. The hips shouldbe strapped in place. The movement of the thigh can thenbe made in the required direction. 64 RECLAIMING THE MAIMED Passive movement of the back can best be done with thepatient strapped at the level of the trochanters prone to a plint,with the body projecting over the end, and supported by anassistant (leg lying) ; the trunk can then be flexed, extended,or rotat
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Keywords: ., bo, bookcentury1900, bookdecade1910, booksubjectwoundsandinjuries