A treatise on orthopedic surgery . enceof the fibula. In 30 the de- fect was partial; of the lowerextremity of the fibula in 17,of the upper extremity in 9,and of the middle in 2 27 cases both fibulae wereabsent or defective, in 68 oneonly—the right in 31, theleft in 25, and in the othersthe side was not 61 cases toes were lacking,and in these cases it may beinferred that the correspond-ing metatarsal bones were ab-sent also. The fourth andfifth toes were absent in 27cases; the little toe alone wasmissing in 15. In many in-stances, as is usual in casesof defective developm
A treatise on orthopedic surgery . enceof the fibula. In 30 the de- fect was partial; of the lowerextremity of the fibula in 17,of the upper extremity in 9,and of the middle in 2 27 cases both fibulae wereabsent or defective, in 68 oneonly—the right in 31, theleft in 25, and in the othersthe side was not 61 cases toes were lacking,and in these cases it may beinferred that the correspond-ing metatarsal bones were ab-sent also. The fourth andfifth toes were absent in 27cases; the little toe alone wasmissing in 15. In many in-stances, as is usual in casesof defective development, de-formity of other parts waspresent; for example, in 17instances the patella was ab-sent or undeveloped and in11 the upper extremitieswere ^ Etiology—The cause of de-formity, associated with ab-sence of bone, may be eitheran original defect in thegerm or it may be due to in-terference with its develop-ment. In some instancesamniotic adhesions may beone of the predisposingcauses; the sharp bend in the Fig. Defective formation of the lower limb,with absence of fibula. At the age of5 years, the difference in the length ofthe limbs was 4% inches. At 14 yearsthe defective limb was 7 inches shorter,the deficiency being equally divided be-tween the tibia and the femur. ^ Cotton and Chute, Boston Medical and Surgical Journal, 1898, Nos. 8and 9 (128 cases). Mazzitelli, Arch. Ortopedia, 1898, F. 5. Boinet, EevuedOrthopedic, November, 1899. Vide also Emil Hain (113 cases), Mechanieotherapie und Unfal Chir., 1903, Bd. i., H. 1. 844 OFTHOPEDIC SFEGEBY. tibia, so often present, may be due to the lessened resistance ofthe defective part. Treatment.—The indications for treatment are to correct thedeformity of the foot in the nsnal manner. The bend in thetibia may be straightened by manipulation and splinting, or byosteotomy if necessary. When the patient begins to walk thefoot must be supported. A light steel upright on the outer sideof the leg, prov
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
