. SPRING FOR DEALING WITH I-OOT-DROP. (Reproduced by pcnnission of the Oxford Medkal Publications.) the prevention as well as cure of certain deformities. He would thicken the sole of a shoe, attach a weight to a crooked shoulder or massage a hunchback, as a logical outcome of his belief in the evils wrought by a faulty posture. In France, in fact, was born a realisation of the importance of muscle action in the shaping of bones. Delpech was next on the scene. He was the scientific bedside observer ; and from a study of his patients he was driven to the conclusion that deformities such as club
. SPRING FOR DEALING WITH I-OOT-DROP. (Reproduced by pcnnission of the Oxford Medkal Publications.) the prevention as well as cure of certain deformities. He would thicken the sole of a shoe, attach a weight to a crooked shoulder or massage a hunchback, as a logical outcome of his belief in the evils wrought by a faulty posture. In France, in fact, was born a realisation of the importance of muscle action in the shaping of bones. Delpech was next on the scene. He was the scientific bedside observer ; and from a study of his patients he was driven to the conclusion that deformities such as club-foot must be attributed to unbalanced muscular action. So we find him in 1816, at Montpellicr, performing the pioneer operation of tendon-cutting, or tenotomy, by which he released the deformed part from the unbalanced pull of the more active muscle (the tendon or " leader " being the means of its attachment to bone). From its extreme simplicity, its great value, and the frequency of conditions in which such an obstacle to free movement is present, the operation with various modilications is still extensively employed. To-day, however, we must regard tenotomy in most cases merely as a remedy for conditions which were avoidable or preventable in the first place. Con- tinued overaction of one set of muscles, with weakened muscles opposing it, brings about permanent shorten- ing of the active set, and stretching with still further weakening of the less active; a vicious circle is estab- lished, and finally a fixed deformity of the joint is produced. Clearly the process should be recognised at its first inception, before definite secondary changes have occurred in muscles and neighbouring structures, and the onset of deformity should be prevented by support of the weaker muscles with splints. A toe-raising spring is illustrated in Fig. i, such as has been extensively employed for the prevention of deformity following foot-drop, a condition which occurs through injury of
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