Fractures, dislocations, deformities and diseases of the lower extremities / by Hugh Owen Thomas.

  • Thomas, Hugh Owen, 1834-1891.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Fractures, dislocations, deformities and diseases of the lower extremities / by Hugh Owen Thomas. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    any other means yet published. Money may be spent upon machinery, so-called spring plates, rubber pads, and steels, but they cannot assist so effectively as a few penny'sworths of leather used to vary the boot sole. There are three classes of feet, the excellent, the medium, and the bad. The first wear the outer side of shoe heels more than the inner side, the medium vvear the heels level, the bad ones wear down the inner edge and posterior curve of the heels. By a modification of the boot sole it is possible to make a bad foot behave like an excellent one. Here are sketched four cases which will be useful guides to practice and will facilitate my demonstration. Mrs. E. brings her son, 6 years of age, to surgeon A. for advice regarding tlie boy's feet. She commences the consultation as follows : Now doctor, we have noticed of late, that this boy has a h:ibit of walking with his toes turned inwards ; this bad habit we have tried to correct by discipline, but we cannot make him do as he has been told—that is, to keep his feet turned out in walking. His father and 1 would like to know if he requires steels to wear? The sm-geon requests to see the feet exposed and, while the stockings are being re- moved, examines the boy's boots and sees that the heels have been slightly worn uneven, down on their inner edges , also that the inner wiugs of the boot uppers have been indented by the inner maleolus of the ankle. The boy's feet being now ban d, the surgeon notices on his standing, that by the weight of the body the foot veiy slightly tends to rotate outwardly, the inner maleolus to slightly pro- ject inwardly ; yet withal, there is no distinct deformity. The surgeon, diag- nosing the initial tendency to splay of the feet, informs Mrs. E., first, that steels are not required ; secondly, that the remedy for the existing condition, is to assist the boy to continue the inturn of his feet ; thirdly, that hitherto, the boy was making, by his will, directed to his calf muscles, an effort to avoid deformity : fourthly, that these muscles, subjected to too continuous an effort would become tired, then probably, the feet might rapidly splay, other muscles then coming into play—but only to aggravate the difficulty. That the remedy is simply to specially form the boot heels, and that leather will do the labour,which at present, is continually thrown upon certain muscles, which are