A treatise on orthopedic surgery . ast of the sole of thefoot. The anterior extremity of the brace is made nearly aswide as the foot, and extends forward slightly beyond the meta-tarsophalangeal articulations. As a rule, a slight general con-vexity is efficient, but in certain instances this must be greatestbehind the sensitive joint to relieve the pain. The brace shouldalso support the longitudinal arch to hold the foot securely andto relieve some of the pressure on the metatarsal region. Incertain instances one or more of the metatarsophalangeal articu-lations may be sensitive to motion. In
A treatise on orthopedic surgery . ast of the sole of thefoot. The anterior extremity of the brace is made nearly aswide as the foot, and extends forward slightly beyond the meta-tarsophalangeal articulations. As a rule, a slight general con-vexity is efficient, but in certain instances this must be greatestbehind the sensitive joint to relieve the pain. The brace shouldalso support the longitudinal arch to hold the foot securely andto relieve some of the pressure on the metatarsal region. Incertain instances one or more of the metatarsophalangeal articu-lations may be sensitive to motion. In such cases the plate mustextend from the heel to the extremity of the sole in order tosplint the foot for a time. If there is slight depression of the 760 OETHOPEDIC SUPiGEEY. longitudinal arch it may be further corrected by raising theinner border of the heel and sole of the shoe; but if it is morepronounced a flat-foot brace (Fig. 488) may be employed, whoseanterior extremity is modified to support the metatarsal arch. Fig. Exercise for the weakened metatarsal arch. If, on the otherhand, the arch is exaggerated and if dorsal flexionis limited, treatment with the aim of relieving this deformity willbe necessary, as described under contracted foot. When theimmediate symptoms of pain and local discomfort have beenrelieved, the patient must endeavor to strengthen the naturalsupports of the arch by proper functional use of the foot, and byregular exercises of the muscles, more especially by methodicalforced flexion of the toes, as this motion elevates the anteriormetatarsal arch (Fig. 498). Massage of the foot and forciblemanipulation of the toes for the purjDose of overcoming restric-tion of motion are of special value. If the depressed anterior arch is rigid, as in some instances,its flexibility must be restored by manipulation or by forciblecorrection under anaesthesia before a brace can be applied. Ifthe symptoms are very acute, and jDarticularly if they have fol-lowed d
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
