A treatise on orthopedic surgery . of the causes of constraint, and thus of ultimate deform-ity, appears to be the interlocking of the feet. Many museumspecimens show this, and in some of the cases of talipes seen dur-ing the first weeks of life the feet may be replaced in the atti-tude in which they had been fixed before birth (Fig. 337).Intrauterine pressure, although not usually the direct cause of ^ Die Pathologie und Therapie des Klumpfusses Heidelberg, 1899.^Boston Medical and Surgical Journal, October 27, 1887. 792 OETHOPEDIC SVBGEFiT. club-foot, undoubtedly has an influence in aggravat
A treatise on orthopedic surgery . of the causes of constraint, and thus of ultimate deform-ity, appears to be the interlocking of the feet. Many museumspecimens show this, and in some of the cases of talipes seen dur-ing the first weeks of life the feet may be replaced in the atti-tude in which they had been fixed before birth (Fig. 337).Intrauterine pressure, although not usually the direct cause of ^ Die Pathologie und Therapie des Klumpfusses Heidelberg, 1899.^Boston Medical and Surgical Journal, October 27, 1887. 792 OETHOPEDIC SVBGEFiT. club-foot, undoubtedly has an influence in aggravating thedeformity. The effect of pressure is not infrequently shownin atrophic areas of skin, and burs£e even are sometimes foundover prominent bones. Entanglement in the umbilical cord, the direct pressure ofintrauterine or extrauterine tumors and the like may be men-tioned also as possible causes. Evidence of restraint and of abnormal attitudes of the limbsis seen not infrequently in connection with club-foot; for ex- FiG. Intrauterine amputations. The patient is a tailor. ample, in hyperextension or fixed flexion of the knees, and incases of extreme deformity, the foot is often smaller than normaland otherwise asymmetrical. The distorted foot may be imperfect in structure; toes maybe absent, spontaneous amputation (Fig. 525) or constrict-ing bands about the leg or foot may be present. Such abnor-malities are usually ascribed to amniotic adhesions. Talipesmay be combined with evidences of impaired or arrested devel-opment ; with harelip, extrophy of the bladder, spina bifida, DEFOEMITIES OF THE FOOT. 793 and absence of patellae; or with other deformities, such as club-hand and wryneck, fixed flexion at the knees, and the like; orthere may be evidence of intrauterine disease, as in anchylosisof joints (Fig. 523) or so-called foetal rickets. Finally, de-formities of the foot may be accompanied by other deformitiesand malformations, showing evidently an abnormality in theo
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
