The Ankle Joint. 383 



divided, when tenotomy is indicated to correct talipes 

 varus, i.e., the condition in which the inner border of the 

 foot is drawn up and the anterior part adducted, so that 

 the patient walks on the outer side of the sole of the foot. 

 (2) Extensor longus digitorum. To divide the tendons 

 of this muscle, occasionally necessary in talipes calcaneus, 

 in which the patient walks on his heel, the knife should be 

 entered on the inner side of the innermost tendon about 

 the level of the ankle joint, avoiding the artery, which here 

 lies internal to the tendon and between it and the extensor 

 proprius hallucis. ( 3 ) The tibialis posticus is divided above 

 the upper limit of its synovial sheath, i.e., at a point about 

 one and a half inches above the tip of the malleolus. The 

 long saphenous vein, which crosses the inner border of the 

 tibia, about two inches above the joint, must be avoided. 

 In the infant this tendon should be cut about half an inch 

 above the tip of the malleolus; In the operation, the knife 

 should be entered between the inner margin of the tibia 

 and the tendon, but, should it be impossible to feel this 

 margin of the bone in a very fat infant, the guide to it is a 

 point, midway between the anterior and the posterior bor- 

 ders of the leg, in the situation mentioned (Little). (4) 

 The peroneus longus and brevis are divided above the 

 level of their common synovial sheath, viz., about one and 

 a half inches above the tip of the outer malleolus. (5) 

 Tendo Achilles. For this, the section is made at the nar- 

 rowest part of the tendon, i.e., about one inch above its in- 

 sertion into the os calcis, avoiding the external saphenous 

 vein which, in this situation, lies a little anterior to the 

 outer margin of the tendon. 



