348 SPRAIN OF THE FLEXOR TENDONS. 



The Parts sprained are naturally supposed to be " the 

 sinews." But sinews or tendons being tissues both inelastic and 

 (per physical force) inextensible, they, themselves, can neither be 

 stretched nor strained, so long as they maintain their cohesion of 

 substance. To discover, therefore, in what part the sprain or lesion 

 is likely to be situate, it will be advisable to submit the leg in its 

 normal state to anatomical examination. 



If we strip or dissect off the skin from the flexor tendons, we 

 find, underneath, between them and the skin, a quantity of loose 

 cellular tissue ; cutting away which we come to a close or proper 

 tunic of the same substance immediately enveloping the tendons. 

 This under or proper covering, however, is fibrous as well as cel- 

 lular in composition. For the space of a hand's breadth below 

 the knee, the glistening (tendinous) fibres may be seen crossing 

 obliquely over the tendons, as they run from the annular ligament 

 of the knee to be implanted into the external border of the cannon 

 bone, behind the external splint bone. This forms the sheath of 

 the tendons. And when we slit it open, we discover a cavity 

 possessing a surface of a synovial nature ; and a sac or bursa 

 thereby formed, which extends half way down the leg, and is 

 there closed. Through the bursa runs the perforans tendon, which 

 may indeed be said to form a posterior boundary to it. The in- 

 terval between the flexor tendons and the suspensory ligament, 

 in their front, is likewise filled with inter-uniting cellular sub- 

 stance. This brief and imperfect anatomical sketch may serve to 

 illustrate the 



Nature of Sprain. It will at once strike us, that, although 

 the tendons themselves are incapable of extension, and are too firm 

 and strong in their texture to sustain hurt from any common acci- 

 dent, yet that they are surrounded, and connected together, as well 

 as to the parts contiguous to them, by a soft delicate tissue which 

 must, every time they are forcibly pulled or stretched, be extremely 

 liable to stretch and laceration ; and this, in fact, it is, which, in all 

 ordinary cases, constitutes the true and sole nature of *' sprain of the 

 back sinews." Coleman defined such a sprain to be " an inflamma- 

 tion of the cellular tissue connecting the perforatus and perforans 

 tendons together;" and this was taking a fair general view of its 



