A treatise on orthopedic surgery . the exaggerateddepth of the arch, the dorsum projects, the cuneiform bones areprominent, and the head and body of the displaced astragalusmay be felt beneath the skin on the anterior surface of the the slighter degrees of the deformity, when the patient stillwalks upon the sole of the foot, the toes are usually dorsiflexed—an attitude due apparently to the overaction of the extensorlongus digitorum and proprius hallucis, as aids in dorsiflexion54 850 OBTHOPEDIC SUBGEBY. (Fig. 575). In rare instances, and only in those cases inwMchall the anterior musc
A treatise on orthopedic surgery . the exaggerateddepth of the arch, the dorsum projects, the cuneiform bones areprominent, and the head and body of the displaced astragalusmay be felt beneath the skin on the anterior surface of the the slighter degrees of the deformity, when the patient stillwalks upon the sole of the foot, the toes are usually dorsiflexed—an attitude due apparently to the overaction of the extensorlongus digitorum and proprius hallucis, as aids in dorsiflexion54 850 OBTHOPEDIC SUBGEBY. (Fig. 575). In rare instances, and only in those cases inwMchall the anterior muscles are paralyzed, the toes may be plantarflexed the patient walking upon their dorsal surfaces. The cavus or increased depth of the arch is due primarily tothe flexion of the forefoot at the mediotarsal joint, and in manyinstances this dropping of the forefoot is in great degree respon-sible for the equinus; in fact, the os calcis is rarely plantarflexed to the degree commonly found in the ordinary congenital equinus. Fig. Acquired talipes equinus, stiowing tlie limit of dorsal flexion. The cases of slight equinus combined with cavus have beendescribed already under the title of the Contracted Foot (page748). Etiology.—Equinus is the most common of the forms of tali-pes acquired in later life. Anterior poliomyelitis, although byfar the most common cause, is by no means as important in theetiology of this as of other varieties of deformity. The nervesupply of the anterior muscles of the foot seems to be particu-larly susceptible, and toe-drop, from neuritis of various types, isnot uncommon. Equinus may be a result of disease of cerebral origin, or even,in rare instances, of pseudohypertrophic muscular paralysis,locomotor ataxia, and the like. It is sometimes induced byhabitual posture, as by long confinement in bed for the treat-ment of fracture or during the treatment of hip disease by ap- DEFOBMITIES OF TEE FOOT. 851 Fig. 576. j>aratiis. Or the contraction may be
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