578 



APPLIED ANATOMY. 



Treatment. In painful pronated and flat feet the contracted muscles can be 

 relaxed by perfect rest in bed. Next the arch can be supported by pads or plates 

 beneath the instep and the weakened muscles strengthened by massage, electricity, 

 or appropriate exercises while the exciting cause of overwork is removed. In para- 

 lytic valgus, the foot may be brought straight by forcible stretching and held there 

 by appropriate apparatus; or an artificial ankylosis (arthrodesis) of the subastragaloid 



FIG. 598. Talipes equinus. 



and ankle-joints may be made to hold the foot in position; or the peroneal or other 

 tendons, on the outer side of the foot, may be transplanted to the inner. 



Talipes Equinus. This sometimes exists as a pure form but it often accom- 

 panies varus and sometimes valgus. It is caused by a paralysis of the extensor 

 muscles. The tendo calcaneus is contracted and the patient walks on the toes. By 

 division or lengthening of the tendo calcaneus and forcible flexion of the foot the 



FIG. 599. Talipes calcaneus. 



FIG. 600. Talipes cavus. 



heel may be brought down but the foot will ' ' flop' ' in a more or less flail-like con- 

 dition from the leg. To remedy this either an apparatus is employed or some- 

 times the peroneal muscles or some of the flexor tendons are brought forward and 

 the effort made to have them fulfil the function of the paralyzed extensors, which 

 latter may also be shortened (Fig. 598). 



Talipes Calcaneus and Talipes Cavus. These result from paralysis of the 

 muscles of the calf or of most of the flexor and extensor muscles (Figs. 599 and 600). 



