A treatise on orthopedic surgery . y toAvard varusor valgus. This is especiallynoticeable in those of paralyticorigin. Symptoms.^The effects ofthe deformity vary. If the limbis actually shorter than its fel-low, so that the lengtheningcaused by the extension of thefoot is no more than a sufficient compensation, and if the foot isfirmly fixed in the deformed position, there is but little dis-ability and the principal discomfort is from corns or callusesbeneath the metatarsal bones. If the limb is not shorter, the additional length caused by theequinus must be compensated by a tilting of the pel
A treatise on orthopedic surgery . y toAvard varusor valgus. This is especiallynoticeable in those of paralyticorigin. Symptoms.^The effects ofthe deformity vary. If the limbis actually shorter than its fel-low, so that the lengtheningcaused by the extension of thefoot is no more than a sufficient compensation, and if the foot isfirmly fixed in the deformed position, there is but little dis-ability and the principal discomfort is from corns or callusesbeneath the metatarsal bones. If the limb is not shorter, the additional length caused by theequinus must be compensated by a tilting of the pelvis andlateral deviation of the spine. This often causes discomfort inthe lumbar region. The gait in this class of cases is alwaysawkward, giving the impression as of stepping over an obstacle. If the foot is not fixed in the attitude of equinus^—that is, ifit hangs downward when it is lifted—the gait is very awkward,because of the insecurity and because of the exaggerated flexionat the knee necessary to lift the pendent Tuberculous Rheumatismequinus deformity. and 852 OBTHOPEDIC SUBGEBY. If the equinus is extreme the limb is usually flexed at theknee when in use. If the equinus is so slight that the foot maybe used in the plantigrade position, the strain resulting from thelimitation of dorsal flexion is felt at the knee; and in childhoodespecially there is often a well-marked tendency to overextensionor recurvation, caused by the effort to place the heel upon theground. In the slight degrees of equinus, discomfort about the calf isexperienced; the limitation of dorsal flexion causes a shortenedstride and awkward gait, while an unguarded step that throwsa sudden strain upon the rigid heel cord is felt as a shock andstrain through the leg and body. Very often the patient com-plains of pain about the metatarsal bones (anterior metatar-salgia), and if the equinus is accompanied by a slight degree ofvalg-us, as is not uncommon, symptoms of the weak foot may bepresent. Th
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
