. The surgical treatment of the common deformities of children . y partof the instrument, as these are very sluggish intheir healing. Cases where the deformity is caused partly byparalysis of the peronei and long extensors, andpartly by spasm of the opposing muscles, are some-what more favourable for treatment, and may oftenbe benefited by tenotomy, but the risk must beborne in mind that the surgeon, by operating, mayfurther increase the helplessness of the limb. The cases of acquired equino-varus which givethe best results under treatment, are also the leastcommonly met with, namely, those in
. The surgical treatment of the common deformities of children . y partof the instrument, as these are very sluggish intheir healing. Cases where the deformity is caused partly byparalysis of the peronei and long extensors, andpartly by spasm of the opposing muscles, are some-what more favourable for treatment, and may oftenbe benefited by tenotomy, but the risk must beborne in mind that the surgeon, by operating, mayfurther increase the helplessness of the limb. The cases of acquired equino-varus which givethe best results under treatment, are also the leastcommonly met with, namely, those in which spas-modic contraction is the active cause of thedeformity. Tenotomy may here be undertakenwith almost as favourable a prognosis as in thecongenital condition, and in all its details of per-formance, and of after-treatment, the proceeding ACOUIRFD FORMS OF CLUB-FOOT. 171 differs in no essentials from that which has beenalready described (p. 144.) Acquired equinus club-foot.—The commonest, and 2- Equina,the most important of the non-congenital deformi-. Fig. 66 — Acquired spastic equinus club-foot (Adams . ties may arise from a number of different causes, Maf. be sp;,! ^ moilic, or and may be spasmodic or paralytic, or may be j;-1^1 ?due to combination of these conditions. Anequinus club-foot has these characteristics (see ); the heel is pulled up towards the calf, to avarying extent, and the foot is therefore rigidly ex-tended ; the tendon Achilles stands out prominently,and there is a notable increase in the arching ofthe foot, caused by a flexion at the transverse tarsaljoint (Fig. 67). In long-standing cases this resultsin the shortening of the plantar ligaments andfascia, and of the muscles in the sole of the astragalus can usually be felt prominently infront of the ankle, there is no deviation either tothe varus, or the valgus side, and little, if any,true bony deformity. 172 CHILDRENS DEFORMITIES. The toes are usually drawn up like the claws of a
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Keywords: ., bookcentury1800, booksubjectabnormalitieshu, booksubjectchildren
