584 The Zwibs as a Whole. 



The metatarsal bone is directed downwards and inwards, and 

 the two form an angle at the metatarsal phalangeal joint, which 

 is itself considerably enlarged and projects inwards. 



G. C. 3519. 



11. 47. Knock-knee and Talipes Varus.— Bones forming the 



skeleton of the lower limbs of an elderly person — macerated, 

 illustrating the above. 



The deformity has been much more pronounced on the left 

 side. 



The upper ends of both femora show similar changes. The 

 angle of the neck approaches a right angle in each case. The 

 shaft is unusually straight, and a ridge of bone is prolonged 

 from the spiral line along the inner side. The articular surfaces 

 are normal. On the left side the shaft from the junction of 

 the middle and lower thirds downwards has the appearance of 

 having been bent outwards, and the inner condyle has projected 

 markedly downwards. Part of the surface of the inner condyle 

 has been injured in the process of maceration, but enough 

 remains to show that its contour has been rounded. The 

 contour of the outer condyle, on the other hand, is flat, as if the 

 bone had been compressed. The articular surface of the outer 

 ■condyle is irregular, and the margins show an overgrowth of 

 bone, such as is seen in arthritis deformans. This latter change 

 is seen also on the lower end of the right femur, which, 

 however, may otherwise be considered as normal. 



The tibise, and especially the left, are both altered towards 

 the upper end bj^ a twisting of the head of the bone inwards 

 upon the shaft. In addition, on the left side the outer 

 tuberosity has sunk markedly down, and the articular margins 

 have irregular projections. The iTpper part of the shaft is 

 distorted by an apparent flattening from before backwards. 



The fibulae have been bent forward at the lower end, 

 and twisted with the tibia at the upper. The margins of 

 the outer maleoli are irregular, and the grooves for the 



