5 6 2 APPLIED ANATOMY. 



The Treatment of Affections of the Feet. The foot is exceptionally 

 accessible both for diagnosis and treatment. The bones and joints are accessible 

 often to both sight and touch, and one should know where to look and feel for them. , 

 Exploratory operations in this portion of the body are out of place. An accurate 

 knowledge of the structures of the foot is absolutely essential to intelligent treatment. 

 The deformities are dependent on muscular action, and one should know the position 

 of the tendons and the influence of the muscles. In amputating, a knowledge of the 

 joints is essential. The problems presented are largely of a mechanical nature, to be 

 solved by a thorough knowledge of the structures and the application of mechanical 

 principles to living tissues. 



BONES OF THE FOOT. 



A knowledge of the bony structure of the foot is the key which unlocks its 

 pathology. The bones of the foot are numerous, so as to give it mobility and to 



lessen shocks. If the bones become 

 ankylosed the footing becomes in- 

 secure, balancing is difficult, the 

 gait is altered, and great care is 

 necessary in locomotion to avoid 

 straining and injury. 



The foot is triangular in shape, 

 being broad across the toes and 

 narrow at the heel. Its bones com- 

 pose the tarsus, -metatarsus, and 

 phalanges. Of these the first two 



Astragalus JfHSS^W^vSi Cuboid are essential, but the third is less 



so. Phalanges are more or less 

 for prehensile uses, and as man, as 



Tuberosity of , . .... 



"fifthmetatarsal WC S66 him, enCaSCS hlS lOOt in 



shoes he makes but little use of the 

 toes, hence they are the least im- 

 portant part of the foot. They are 

 used somewhat in walking, and to a 

 greater degree in balancing, climb- 

 ing, running, etc. They add to the 

 efficiency of the foot, but their loss 

 does not impair it to a great extent. 

 Intricate and delicate movements 

 may be interfered with, but the 

 more deliberate firmer movements, 

 as in walking, may remain almost 

 normal. The big toe has only two 

 phalanges and this increases its 

 strength at the cost of mobility. 

 The remaining portion of the foot 

 is composed of the metatarsus and 

 tarsus five bones of the former 

 and seven of the latter. 



The foot bones are divided 



FIG. 578. Anterior view of the bones of the foot showing longitudinally into tWO Sets, an in- 

 their division into internal and external sets. & , J ' 



ternal and external. I he main 



weight of the body is transmitted through the internal set, which is in relation with the 

 tibia. It consists of the astragalus (talus\ scaphoid (navicular} , the three cuneiform, 

 and the inner three metatarsal bones with their corresponding phalanges (Fig. 578). 



The external set is in relation with the fibula, and is composed of the os calcis, 

 cuboid, and outer two metatarsals with their corresponding phalanges. 



As has been pointed out by Quenu and Kuss (Revue de Chirurgie, Jan., 1909, 

 p. i), while the main function of the internal portion of the foot is support, that of 



