The practice of surgery . PODELKOMA. 679 In confirmed cases, both deformity and lameness are great. Theperonei and anterior muscles of the foot obtain a preponderance, andeversion of the foot becomes ultimately as considerable as in true talipesvalgus. The preponderating muscles undergo structural shortening;the outer margin of the foot, and even sometimes the front of the footo-enerally, is raised from the ground; and locomotion is effected to aconsiderable extent on the heel. The gastrocnemii then waste, and thegait becomes very unsightly. Such cases are to be treated as ex-amples of Talipes
The practice of surgery . PODELKOMA. 679 In confirmed cases, both deformity and lameness are great. Theperonei and anterior muscles of the foot obtain a preponderance, andeversion of the foot becomes ultimately as considerable as in true talipesvalgus. The preponderating muscles undergo structural shortening;the outer margin of the foot, and even sometimes the front of the footo-enerally, is raised from the ground; and locomotion is effected to aconsiderable extent on the heel. The gastrocnemii then waste, and thegait becomes very unsightly. Such cases are to be treated as ex-amples of Talipes. Tenotomy is required, with the subsequent use ofrectifying apparatus. And the tendons which require division are, thetibialis anticus, all the peronei, the extensor proprius pollicis, and theextensor longus digitorum. Podelkoma. This has been elsewhere described, as a form of multiple ulcerationpeculiar to the foot [Principles, 3d Am. Ed. p. 254). By others it has Fig. e b a Podelkoma, or morbus tuberculosus pedis, a. The toes, much altered, b. The outer side of the foot, in«ome parts showing cicatrices, c. The line of amputation at the ankle, d. The astragalus. The swelling isoften much greater than here represented. been noticed as morbus tuberculosus The milder forms may beremedied by pressure and constitutional alteratives; the advanced casesgenerally result in amputation. Corns and Bunions. These painful affections are the result of pressure, exerted by ill-con-structed shoes and boots. They are more easily prevented than The shoe or boot should be large enough to contain the foot easily;and an allowance should be made for the occasional swelling to whichthe part is liable by exercise, heat, and a dependent position. 2. Thesole should be at least as broad as that of the foot. The outline of the foot represented on a piece of paper, on which the patient leans in the erect posture should be the measure of the sole of the boot or
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