The practice of surgery . g ligaments. The arch of the foot is lost, the tibia projectsinwards, the foot turns out, the ankle is apt to swell, and progressionis slow, awkward, difficult, and painful. The deformity affects both sexes, and all classes; excited, inFig. 291. the poor, by overwork ; in the rich, by absurd eversion of the feet, andovertasking of the limbs, in at-tempts to impart polite accomplish-ments to these organs. In mostcases, a state of system very similarto the strumous will be found. Bydiscontinuance of the excitingcauses, by friction, by bandagingand the wearing of a robor
The practice of surgery . g ligaments. The arch of the foot is lost, the tibia projectsinwards, the foot turns out, the ankle is apt to swell, and progressionis slow, awkward, difficult, and painful. The deformity affects both sexes, and all classes; excited, inFig. 291. the poor, by overwork ; in the rich, by absurd eversion of the feet, andovertasking of the limbs, in at-tempts to impart polite accomplish-ments to these organs. In mostcases, a state of system very similarto the strumous will be found. Bydiscontinuance of the excitingcauses, by friction, by bandagingand the wearing of a roborantFiat-foot, plaster on the part, and by general tonic treatment, relief is is well also to have the sole of the shoe, or boot, considerably thickeron the inner than on the outer side. And, if matters do not advancefavorably, an apparatus may be worn, which will both support the ankleand invert the foot. Sometimes, the young patient, in the process offarther development, recovers both symmetry and 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. 292.
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