486 



77/6' Leg 



EX.L.D 



between this tendon and that of the extensor longus digitorum, the 

 n^rve being to the outer side of the artery and its vcmc comitcs. 



When effusion the result of a sprain 

 or of gout, for instance takes place into 

 the synovial sheaths of the tendons about 

 the ankle, the outline of the tendons is 

 somewhat obscured, and flexion and ex- 

 tension of the foot are accompanied by 

 painful and strange creakings or crack- 

 lings in the sheaths. 



At the back of the leg: the deep 

 fascia is continuous with the fascia lata 

 of the thigh, and receives some strengthen- 

 ing slips from the biceps, sartorius, grari- 

 lis, and semi-tendinosus. Over the ham, 

 where it is very strong, it is pierced by the 

 short saphenous vein. Lower down, it is 

 continuous with the sheet which covers 

 the peroneus longus and brevis, and it is 

 attached between them, and the solcus 



Synovial sheaths^fronyf ankle. and flexQr longus hallucis, to the fibula. 



Internally it is attached to the posterior 



border of the tibia. It binds down the calf muscles. Another lay* r 

 of deep fascia, as remarked elsewhere (p. 490), passes across beneath 

 the soleus, binding down the tibialis posticus and the flexors longus 

 digitorum and proprius hallucis, covering also the posterior tibial 

 vessels and nerve. 



Towards the inner ankle these two layers of deep fascia blend to 

 form the internal annular ligament, and are then lost in the deep 

 plantar fascia. This annular ligament passes from the inner malleolus 

 to the adjacent part of the os calcis, and binds down the structure* 

 behind the inner ankle. Most internally is the sheath for the tendon 

 of the tibialis posticus, which, like that of the tibialis anticus, has a 

 synovial investment of its own. Close to the outer side of this is another 

 compartment for the tendon of the flexor longus digitorum, with its 

 own synovial investment. Then comes a wide passage for the posterior 

 tibial artery with a vena comes on either side, and, a little farther out, 

 is the posterior tibial nerve. More externally still is the tunnel for the 

 tendon of the flexor proprius hallucis, with its synovial sheath. 



The external annular litrament passes from the tip of the external 

 malleolus to the outer side of the os calcis, and binds down the ten- 

 dons of the peroneus longus and brevis and their common synovia] 

 sheath, the shorter tendon being anterior. The longer tendon is apt 

 to slip from its position and thereby to cause lameness and pain on 

 walking ; this accident may also happen to the tendon of the tibialis 

 posticus as it winds behind the inner malleolus. 



