THE ANTERIOR TIBIOFIBULAR REGION 527 



Applied Anatomy. The Hamstring tendons are occasionally ruptured. In disease of the 

 knee-joint the Hamstrings may contract, flexing the knee, drawing the tibia backward, and some- 

 times causing incomplete dislocation. The tendons of these muscles occasionally require sub- 

 cutaneous <lir/xi</ in some forms of spurious ankylosis of the knee-joint dependent upon per- 

 manent contraction and rigidity of the Flexor muscles, or from stiffening of the ligamentous 

 other tissues surrounding the joint, the result of disease. Division of a tendon is effected by 

 putting the tendon upon the stretch, and inserting a narrow sharp-pointed knife between it and 

 the skin; the cutting edge being then turned toward the tendon, it should be divided, taking great 

 care that the wound in the skin is not at the same time enlarged. The relation of the external 

 popliteal nerve to the tendon of the Biceps must always be borne in mind in dividing this tendon; 

 in fact, a complete exposure of the tendon is much to be preferred. 



IV. MUSCLES AND FASCIA OF THE LEG. 



These may be divided into three groups: those on the anterior, those on the 

 posterior, and those on the outer side of the leg. 



5. The Anterior Tibiofibular Region (Fig. 393). 



Tibialis anticus. Extensor longus digitorum. 



Extensor proprius hallucis. 1 Peroneus tertius. 



Dissection (Fig. 370). The knee should be bent, a block placed beneath it, and the foot 

 kept in an extended position; then make an incision through the integument in the middle line 

 of the leg to the ankle, and continue it along the dorsum of the foot to the toes. Make a second 

 incision transversely across the ankle, and a third in the same direction across the bases of the 

 toes; remove the flaps of integument included between these incisions in order to examine the 

 deep fascia of the leg. 



The deep fascia of the leg (fascia cruris) forms a complete investment to 

 the muscles, but is not continuous over the subcutaneous surfaces of the bones. 

 It is continuous above with the fascia lata, receiving an expansion from the tendon 

 of the Biceps femoris, on the outer side, and from the tendons of the Sartorius 

 (Jracilis, and Semitendinosus on the inner side; in front, it blends with the peri- 

 osteum covering the subcutaneous surface of the tibia, and with that covering the 

 head and external malleolus of the fibula; below, it is continuous with the annular 

 ligaments of the ankle. It is thick and dense in the upper and anterior part of the 

 leg, and gives attachment, by its deep surface, to the Tibialis anticus and Extensor 

 longus digitorum muscles, but is thinner behind, where it covers the Gastrocnemius 

 and Soleus muscles. Over the popliteal space it is much strengthened by trans- 

 verse fibres which stretch across from the inner to the outer Hamstring muscles, 

 and it is here perforated by the external saphenous vein. Its deep surface gives 

 oil', on the outer side of the leg, two strong intermuscular septa which enclose the 

 Peronei muscles, and separate them from the muscles of the anterior and posterior 

 tibial regions. It also gives off several smaller and more slender processes which 

 enclose the individual muscles in each region; at the same time a broad transverse, 

 intermuscular septum, called the deep transverse fascia of the leg, intervenes between 

 the superficial and deep muscles in the posterior tibiofibular region. 



'There is no such word as " Hallux, -cis." It is the result of some ignorant blunder, copied until it has 

 become established by usage; it has been thought better, therefore, to retain it. According to Lewis and 

 Short, the word is AI.LEX, masculine; genitive, ALLICIS, the great toe, and the correct rendering would be 

 Extensor proprius allicis. It is a rare word, and is sometimes spelt, but not so correctly, " Hallex." It is 

 used by Plautus, in the " Poenuhis," V. v. 31. of a little man, as we might say, " a hop-o'-my-thumb." " Tune 

 hie amator audes esse, nUei viri" (To think of you darinx to make up to her, you hop-o'-my-thumb!). The 

 word " alex." sometimes spelt " allex," a fish sauce, is probably a different word altogether. It is used by 

 Horace and Pliny. 



