121 



Fig. 51. 



(Fig. 51). The shortening is due to contraction of the triceps tendon, 

 and thickening of the plantar fascia. 



There are two other varieties ; 

 one in which the toes are drawn up 

 by contraction of the extensors, and 

 the patient walks upon the heel ; 

 and the other when the dorsum or 

 instep comes in contact with the 

 ground. Besides which there may 

 be various complications of the 

 above. 



The prognosis will depend upon 

 the degree of contraction, the va- 

 riety of the deformity, the condition 

 of the bones, and the age of the 

 patient. 



Treatment. — Many cases of con- 

 genital club foot may be rectified 

 by constantly wearing a proper 

 apparatus, especially if the treat- 

 ment be commenced in early child- 

 hood ; but in confirmed cases it is 

 better to resort at once to Stromeyer's operation of division of the 

 tendons. The operation is thus performed. 



The tendon is put on the stretch, and a narrow sharp -pointed 



