A treatise on orthopedic surgery . is grasped firmly near the ankle with the left hand, andwith the right the foot is forcibly twisted in a direction down-ward, outward, and upward, over and over again, with steadilyincreasing force as the tissues slowly yield, until it may beforced into a position of extreme abduction, so that the sole maybe made to look outward and downward—the reverse of theformer attitude. DEFOEMITIES OF THE FOOT. 817 One next stretches the contracted plantar fascia and reducesthe cavus which is usually present by forcing the forefoot towarddorsiflexion,, against the resis
A treatise on orthopedic surgery . is grasped firmly near the ankle with the left hand, andwith the right the foot is forcibly twisted in a direction down-ward, outward, and upward, over and over again, with steadilyincreasing force as the tissues slowly yield, until it may beforced into a position of extreme abduction, so that the sole maybe made to look outward and downward—the reverse of theformer attitude. DEFOEMITIES OF THE FOOT. 817 One next stretches the contracted plantar fascia and reducesthe cavus which is usually present by forcing the forefoot towarddorsiflexion,, against the resistance of the contracted tendo Achil-lis, until the sole is made perfectly flat (Fig. 549). Finally,the fourth, and often the most difficult part of the rectification—that of forcing the displaced astragalus into its proper positionbetween the malleoli—is attempted. To accomplish this thetendo Achillis is first divided subcutaneously, and, if necessary,the posterior ligament of the aiikle is also divided at the same Fig. Reduction of the equinus deformity. (Lorenz.) time. The patient is then turned upon his face so that with theknee resting on the table the leg is held upright. This allowsone to hook the fingers about the extremity of the os calcis, whilethe hand and arm, lying along the sole of the foot, may be usedas a lever to force it toward dorsal flexion as the os calcis isdrawn downward. In this manner forcible stretching is con-tinued until the dorsum of the foot can be brought almost intoapposition with the crest of the tibia. When the operation hasbeen completed the foot should be perfectly limp. It is usually52 818 OETHOPEDIC SrSGEEY. someTvhat congested from the pressure of the fingers, but it iswarm and the circulation is unimpaired. One may assume that in the transformation of rigid deformityto yielding tissues that can be moulded into the desired shape,the component parts of the deformed foot must have been sub-jected to considerable violence; that lig
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
