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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    the alteration correctly. They generally make a hump at B, ¥\g. 4, and also neglect to slope or crook the heel, so that whether we look at the inner or outer aspect of the shoe, a wedge is seen as in Fig. 4, which should only show on the inner aspect. As the wedge B C, Fig. 4 is very noticeable when the boot is examined in your hands.a shoemaker concludes that a mere uniform wedge is required and the most important, because it is the greatest observable alteration, whereas to the surgeon, the crooked heel, which is not readily observed, is the most valuable alteration. So to make sure that the sufferer gets an efficient boot, the surgeon, besides instructing the shoemaker, should inspect the change before the boot is delivered for use, and if any repair be afterwards required, he should still distrust the repairer, and again inspect. This is my conclusion after twenty-four years' wrangling with St. Crispin's fraternity. No boot can be properly converted to suit a splay foot if the heel point be not as wide as the heel part of the foot sole. The extreme form of splay foot is so well known to surgeons that there is no need of my giving here a description. Two varieties are presented for treatmsnt, one with the foot fixedly everted by contraction of the peronei muscles, another in which the muscular part of the extensors of the toes is also contracted. These two forms of splay feet can, by the wearing of shoes with sloped heel and sole, be relieved from much discomfort, but mere mechanical aid will not correct the inversion and the limited radius of extension; to remedy which, the operation of teno- tomy should be performed, dividing the tendons of the peronei, to relieve fixed eversion, and also the tendons of the extensors