194 ANATOMY IN A NUTSHELL. 



We have the following forms of club-foot: (1) Talipes equinus in which the 

 heel is elevated and the weight of the body thrown upon the anterior portion of 

 the foot. (2) Talipes calcaneus in which the patient walks upon the heel. (3) 

 Talipes cavus or arcuatus in which there is an increased curvature in the arch of 

 the foot. (4) Talipes varus in which the footis turned inward the patient walk- 

 ing on the outer border. (5) Talipes valgus (flat or splay foot) in which the 

 foot is everted or distorted outward. Combinations of these may occur, such as 

 Talipes equino-varus, Talipes ealcaneo-varus, Talipes calcaneo-valgus, Talipes 

 equino-valgus. (Plate LXXXIX.) 



The following are some of the principal amputations of the whole or part 

 of the foot. (1) Syme's amputation is made at the ankle-joint, leaving a large 

 heel flap and removing the internal malleolus and the external malleolus and 

 sometimes a slice from the lower part of the tibia. (2) Roux's amputation is 

 made at the ankle-joint, leaving a large internal flap. (3) Pirogoff's amputa- 

 tion is made by removing all the tarsal bones, except the posterior part of the os 

 calcis, and a thin slice from the tibia and fibula including the two malleoli. The 

 small portion of the os calcis which remains is then turned up and united to the 

 lower surface of the tibia. (4) Sub-astragaloid amputation is made by removing 

 all the bones of the foot except the astragalus. This operation is rarely per- 

 formed. (5) Chopart's amputation is made by removing all the bones of the 

 foot except the os calcis and astragulas. (6) Lisfranc's amputation is made by 

 removing all the metatarsals and phalanges, but not cutting any of the bones. 

 (7) Hey's amputation is a modification of Lisfranc's amputation by sawing 

 through the internal cuneiform bone. (8) Skey's amputation is a modification 

 of Lisfranc's amputation by sawing off the base of the second metatarsal bone. 

 A combination of Pirogoff's and the sub-astragaloid is Hancock's amputation. 



LESSON LI I. 

 Hip-Joint. (Plate LXXXII.) 

 This joint is a diarthrodial joint and belongs to the subclass enarthrodial. 

 It has five ligaments. (1) The capsular ligament, which is very strong and 

 fibrous, surrounds the brim of the acetabulum, beingjust external to the coty- 

 loid ligament. Below it is attached to the neck of the femur into the anterior 

 intertrochanteric line anteriorly, to the root of the neck of the femur superiorly, 

 and to the middle of the neck of the femur posteriorly. It has two sets of fi- 

 bers, circular and longitudinal. The circular are best developed at the lower 

 and posterior part where they form a collar called the zona orbicularis or liga- 

 ment of Bertin. The longitudinal fibers form the accessory ligaments. Some- 

 time- there is an opening in the front of the capsular ligament for the passage of 

 synovial membrane to form a bursa under the Psoas magnus. (2) The ilio- 

 femoral or V ligament is accessory to the capsular ligament, it is bifurcated below 

 and is connected to the anterior intertrochanteric line at its outer and inner 

 portions and it is attached above to the anterior inferior spine of the ilium. 

 (a) The ischio-capsulab ligament is an accessory ligament being attached 

 to the ischium below the acetabulum and passing through the circular fibers 



