A treatise on orthopedic surgery . r and earlier casesthe diagnosis is not always so easily made. Diagnosis.—In all cases of suspected weakness of the foot athorough and orderly examination should be made, not only ofits appearance, but also of its functional ability. Such an ex-amination is not merely for the purpose of diagnosis, but inorder that the degree and character of the temporary or perma-nent changes in structure and function may be properly esti-mated. Attitudes.—One begins the examination by noting the mannerof standing and walking. The heel walk, the exaggerated turn-ing out of t
A treatise on orthopedic surgery . r and earlier casesthe diagnosis is not always so easily made. Diagnosis.—In all cases of suspected weakness of the foot athorough and orderly examination should be made, not only ofits appearance, but also of its functional ability. Such an ex-amination is not merely for the purpose of diagnosis, but inorder that the degree and character of the temporary or perma-nent changes in structure and function may be properly esti-mated. Attitudes.—One begins the examination by noting the mannerof standing and walking. The heel walk, the exaggerated turn-ing out of the feet, the slouchy gait in which the leg is nevercompletely extended, in which the power of the calf muscle isnot applied, and in which the essential postures of the foot are 718 OBTEOPEDIC SUEGEBY. disused, are all elements of weakness that should be correctedwhether they cause symptoms or not. Distribution of Weight and Strain.—The distribution of theweight of the body and the habitual use of the foot are often Fig. The ordinary type of weak foot in a child. The attitude of abduction causes theapparent flat-foot. (See Fig. made evident by examining the worn shoe. If it is bulged in-ward at the arch or worn away on the inner side of the sole itshoAvs weakness (Fig. 475). The same observations are thenmade on the bare feet, particular attention being paid to the lineof strain or leverage; thus a line drawn down the crest of thetibia from the centre of the patella, continued over the foot,should meet the interval between the second and third toes; ifit falls over or inside the great toe. it shows that the foot isworking at a disadvantage (Fig. 469). Contour.—The contour of the foot should then be examined*its internal border should curve slightly outward, so that if thefeet are placed side by side with the toes and heels in appositiona slight interval remains between them; if this slight concavity DISABILITIES AND DEFORMITIES OF TEE FOOT. 719 is replaced by
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