THE LEG AND ANKLE. 53 



The head of the fibula is a good landmark on the outer 

 side of the leg, about one inch below the top of the tibia and 

 nearly on a level with the tubercle. Observe that it is placed 

 well back, and that it forms no part of the knee-joint, and 

 takes no share in supporting the weight. 



The shaft of the fibula arches backwards, the reverse of 

 the shaft of the tibia. The fact of the bones not being on the 

 same plane should be remembered in flap amputations. The 

 shaft of the fibula is so buried amongst the muscles, that the 

 only part to be distinctly felt is the lower fourth. Here there 

 is a flat triangular subcutaneous surface, between the pero- 

 neus tertius in front, and the two peronei (longus and brevis) 

 behind. Here is the most frequent seat of fracture. 



1 1 6. Xttalleoli. The shape and relative position of the 

 malleoli should be carefully studied, as the great landmarks 

 of the ankle. The inner malleolus does not descend so low as 

 the outer, and advances more to the front : at the same time, 

 owing to its greater antero-posterior depth, it is on the same 

 plane as the outer behind. The lower border of the inner 

 malleolus is somewhat rounded, and the slight notch in it 

 for the attachment of the lateral ligament can be felt. The 

 outer malleolus descends lower than the inner, thus effectually 

 locking the joint on the outer side. Its shape is not unlike 

 the head of a serpent. Viewed in profile, it lies just in the 

 middle of the joint. 



In Syme's amputation of the foot at the ankle, the line of 

 the incision should run from the apex of the outer malleolus, 

 under the sole to the centre of the inner. 



In a well-formed leg, the inner edge of the patella, the 

 inner ankle, and the inner side of the great toe, should be in 

 the same vertical plane. Look to these landmarks in adjust- 

 ing a fracture or dislocation, keeping at the same time an eye 

 upon the conformation of the opposite limb. 



There are several strong tendons to be seen and felt about 

 the ankle. 



117. Tendo Achillis. Behind is the tendo Achillis. It 

 forms a high relief, with a shallow gutter on each side of 

 it. The narrowest part of the tendon, where it should be 



