470 SURGICAL APPLIED ANATOMY. [Chap. xxm. 



upon or in front of the malleolus. No tendon in 

 the body is so frequently displaced as is that of the 

 peroneus longus. 



The tendons about the ankle are frequently 

 divided by operation. The tendo Achillis is usually 

 cut about one inch above its insertion, the knife 

 being entered from the inner side to avoid the 

 posterior tibial vessels. The tibialis posticus tendon 

 is, as a rule, divided just above the base of the inner 

 malleolus. There is, however, enough room between 

 the annular ligament and the scaphoid bone to cut 

 it on the side of the foot. The anterior tibial 

 tendon may be divided readily either in front of the 

 ankle or at its insertion into the internal cuneiform 

 bone. 



Blood-vessels. The lines of the various arteries 

 have been already indicated. Wounds of the plantar 

 arch are serious, on account of the depth at which the 

 external plantar artery lies, and the impossibility of 

 reaching the vessel without making a large wound 

 in the sole that would open up important districts 

 of connective tissue, and do damage to tendons 

 and nerves. The arch is formed by the junction 

 of the external plantar artery with the dorsal 

 artery of the foot, a continuation of the anterior 

 tibial vessel. In cases, however, of bleeding from 

 the arch ligature of both the posterior and anterior 

 tibial vessels at or just above the ankle, would not 

 necessarily arrest the haemorrhage. After ligature 

 of these vessels blood would still be brought in- 

 directly to the arch by means of the peroneal artery. 

 By its anterior peroneal branch this vessel com- 

 municates with the external malleolar branch of the 

 anterior tibial artery, and with the tarsal branch of 

 the dorsalis pedis. By its terminal branch it com- 

 municates with the two last-named vessels, and also 

 with the internal calcaneal branches of the external 



