454 SURGICAL APPLIED ANATOMY. [Chap. xxn. 



sharp pain in the calf during exertion, to which the 

 French give the name " coup de fouet." 



Vessels. The large arteries of the leg, being all 

 in near proximity with the bones, are apt to be in- 

 jured by sharp fragments in fractures of the limb. 

 This especially applies to the peroneal artery, which 

 runs along the fibula, and is in considerable risk of 

 being wounded in fractures about the middle of that 

 bone. It is at the point of bifurcation of the popliteal 

 artery that emboli are peculiarly apt to lodge. They 

 plug the vessel and practically block the three main 

 arteries of the leg. Gangrene therefore not infre- 

 quently follows the occurrence. Billroth states that 

 in all the cases of gangrene of the leg due to embolism 

 that he has met with, the ping was found situated 

 at the bifurcation of the popliteal trunk (" Clinical 

 Surgery," 1881). According to some French surgeons, 

 aneurism of the commencement of the posterior tibial 

 artery is more often associated with gangrene of the 

 leg than is a popliteal aneurism. The reason they 

 assign is the following : The aneurism on the former 

 vessel not only interferes with the passage of the 

 blood into the posterior tibial and peroneal arteries, 

 but also compresses the anterior tibial vessel and with 

 it the anterior tibial recurrent, an artery that is of 

 so great importance in establishing the collateral 

 circulation. 



Varicose veins are more commonly met with in 

 the leg than in any other part of the body, save, per- 

 haps in the hsemorrhoidal and spermatic veins. This 

 depends upon the great length of the veins of the lower 

 limb, the large columns of blood their valves have to 

 support, their vertical position, the liability of the 

 great trunks (iliac) into which they ultimately enter, 

 to be compressed, and upon the fact that the superficial 

 veins, being outside the fascia, lose that assistance to 

 the circulation derived from muscular contraction. The 



