A treatise on orthopedic surgery . mb is fully ex-tended the deformity is most marked, because the shortenedligaments and tissues on the outer aspect of the joint becometense, and because the outward rotation of the tibia is the leg is flexed the deformity lessens, and in the attitude ofcomplete flexion it disappears (Fig. 404). This is explainedby the fact that the posterior surface of the condyles is notaffected by the deformity of the shaft, while the relaxation ofthe ligaments and the outward rotation of the femora allow thetibiae to become parallel with one another. This acco
A treatise on orthopedic surgery . mb is fully ex-tended the deformity is most marked, because the shortenedligaments and tissues on the outer aspect of the joint becometense, and because the outward rotation of the tibia is the leg is flexed the deformity lessens, and in the attitude ofcomplete flexion it disappears (Fig. 404). This is explainedby the fact that the posterior surface of the condyles is notaffected by the deformity of the shaft, while the relaxation ofthe ligaments and the outward rotation of the femora allow thetibiae to become parallel with one another. This accounts for 604 OETEOPEDIC SrEGE:RY. the habitual attitude of slight flexion T\hich is so often assumedbv patients who thus unconsciously accommodate themselvesto the deformity. / Secondary Deformities.—The outward inclination of the leg-throws more weight upon the inner border of the foot and tendsto depress it into the attitude of valgus. Thus knock-knee inweak children is often accompanied by flat-foot, but in the more Fig. Skiagram of Fig. 397, showing the deformity to be due to distortions of thediaphyses of the bones, while the epiphyses are practically normal. extreme grades of deformity the eftorts of the patient to com-pensate for the abnormal separation of the feet may result inhabitual inversion (Fig. 400) ; in fact, confirmed and extremeknock-knee in older subjects is usually accompanied by a slightdegi-ee of varus that ]3ecomes very evident after the correctionof the deformity by operation. Even in the mildest type ofknock-knee this compensatory and conservative effort of natureis shown by the so-called pigeon-toed walk, which is often thefirst symptom that attracts attention. DEFORMITIES OF BONES OF LOWER EXTREMITY. 605 Fig. 402. —The gait of the patient with well-marked genu valgTimis peculiarly awkward and shambling. The knees interfere and must be assisted, as it were, in the effort to pass one anotherin walking. In the slighter cases the thigh is
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
