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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    outside of the ankle, the ball of the foot, the heel, or middle of the sole ; as patients express it, the foot seems heavy, and to have lost its spring; a symptom which I have not seen described is often complained of, a stiffness in the foot; for example, after sitting for any length of time, or on rising in the morn- ing, the feet seem stiff and unmanageable when at- tempting to walk, the sensation lasting several minutes. On manipulation — pressure over the astragalo-sca- phoid articulation is painful — forcibly turning the fore-foot out or in, causes pain here, sometimes also just in front of the external and internal malleoli; forced flexion or extension of the medio-tarsal joint is often attended with pain. These symptoms may, and most often do, come on slowly, and are of long dura- tion, aggravated by overwork, relieved by rest; but they may appear suddenly, as in cases where there has been a gradual breaking down of the arch, a slight unnoticed injury may result in great pain, accom- panied by redness and swelling; really, a sprain occur- ring in a weakened foot. It must be remembered that in old flat feet the dis- placed bones constantly rubbing on each other, pres- sing on their overstretched ligaments, may induce a low grade of inflammation, as shown at autopsies by eroded cartilages, ligaments and porosities of the bones. Such cases might easily be mistaken for chronic rheumatism, if the deformity were slight, especially if, as sometimes happens, but one foot were affected in a person subject to rheumatic inflammation in other joints. The symptoms, too, do not at all correspond with the degree of deformity. Many persons with complete flat-foot have no trouble, while others who are practically disabled by it show.but a slight flatten- ing of the arch. Many flat feet can, by manipulation, be nearly or quite replaced in their normal position, others only partially.