Observations on forty-five cases of flat-foot : with particular reference to etiology and treatment / by Royal Whitman.

  • Whitman, Royal, 1857-1946.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Observations on forty-five cases of flat-foot : with particular reference to etiology and treatment / by Royal Whitman. 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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    be classed as results tliau causes ; for example, in some cases where there is a considerable displacement of the astragalus to the inside, as in Figure 1, it is difficult or impossible for the patient to Hex the foot in an adducted position, as is the ordinary action of the tibialis anticus ; this might be thought due to atrophy of that muscle, but it may be more easily ex- plained by this displacement of the astragalus, which necessitates a wide movement of the fore-foot about its head : if the displacement be so great as to render this impossible, the foot must be flexed and abducted as though it were moved by the long extensor of the toes. 1 have noticed, too, in some of these cases, when attempting manually to flex and abduct the foot, that there seemed to be an abnormal resistance in the calf muscle, w'hich had been acting so long with its tendon displaced outwardly in its relation to the foot. LAX LIGAMENTS. By some, flat-foot has been ascribed to lax liga- ments. As to this, it may be said that some persons have strong muscles, and others weak ones. 8o, too, there is a great difference in ligaments. One has only to examine a certain number of normal joints to con- vince himself of this. It seems reasonable that a person whose muscles are weak and whose joints are loose, will, under favoring conditions, develop flat- foot, while another with strong muscles and closer joints wmuld not. It does not follow', however, that a primary relaxation of ligaments is the ordinary cause of this affection. It is impossible to say how much hereditary influences have to do with the causa- tion of flat-foot. No. 1, of “ flat feet in men,” a case of extreme deformity, informed me that he was one of eight brothers, all of whom had feet as flat as his own. No. 3, already cited, the most extreme case of all, said he had inherited the affection from his father, yet he had three brothers with perfect feet. The oc- cupation, in which he had been engaged for five years.