Notes on Pott's fracture : with a few remarks on the treatment of old cases / by Robert Jones.

  • Jones, Robert, 1857-1933.
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on Pott's fracture : with a few remarks on the treatment of old cases / by Robert Jones. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    NOTES ON POTT’S FRACTURE, WITH A FEW RE- MARKS ON S^E TREATMENT OF OLD CASES. By Robert Jones, Honorary Surgeon to the Stanley Hospital, Liverpool. Alluding to the fracture associated with his name Percival Pott, a hundred years ago, wrote :—“ The inferior fractured end of the fibula falls inwards towards the tibia, that extremity of the bone which forms the outer ankle is turned somewhat out- wards and upwards, and the tibia having lost its proper support, and not being of itself capable-of steadily preserving its true perpendicular bearing, is forced off from the astragalus inwards, by which means the weak bursal or common ligament of the joint is violently stretched if not torn, and the strong ones which fasteu the tibia to the astragalus and os calcis are always lacerated, thus producing at the same time a perfect fracture and a partial dislocation, to which is sometimes added a wound in the integuments made by the bone at the inner ankle; by this means, and indeed as a necessary consequence, all the tendons which pass behind or under, or are attached to the extremities of the tibia or fibula or os calcis, have their natural direction and disposition so altered, that instead of performing their appointed actions they all contribute to the distortion of the foot, and that by turning it outwards and upwards.” Since this description was published no great advance has been made either in the anatomy or treatment of this lesion. Indeed, its limitations are so well defined that there is scarcely room for even an ingenious speculation. The clinical signs are, briefly, a depression over the site of injury, eversion of the foot, a prominent inner malleolus, and a swelling round the ankle- joint. The fracture takes place usually about two inches above the malleolus, the deltoid ligament being often ruptured, and the astragalus separated from the tibia. Before entering upon an analysis of cases it will be better to discuss a little more in detail the various factors which together constitute this injury.