Fig. 194. Outer Side of (Left) Foot. 



Preparation from a girl aged /j years. The Fascia over the Dorsum of the 

 Foot has been removed with preservation of the Annular Ligament, Superficial 

 Veins and Nerves. Fascial Bands which bind down the Peroneal Muscles are 

 slieivn (Retinacnla Peroneorum). Synovial Sheaths of Peroneal Muscles pin k. 



The Superficial Fascia behind the External Malleolus contains the Short 

 Saphenous Vein and Nerve. Over the External Malleolus, (in V2 to Yj cases), there 

 is a small Subcutaneous Bursa. The Peroneal Tendons are held within their grooves 

 behind the External Malleolus b}' strong bands similar to those on the inner 

 side which are derived from the Anterior Annular Ligament. Without these 

 ligaments a displacement of these tendons over the Malleoli would be of frequent 

 occurrence. These bands, the Superior and Inferior Peroneal Bands are thickenings 

 of the fascia. The Superior Band runs from the outer side of the Malleolus to 

 the lower part of the outer surface of the Os Calcis and has under it the tendon 

 of the Long Peroneal and deep to this the tendon of the Short Peroneal Muscle. 



The Inferior Peroneal Band, more distally situated, runs from the Tip of 

 the Malleolus to the outer surface of the Os Calcis : a Septum separates these two 

 muscles, of which the Short Peroneal lies anteriorly. 



Both the Peroneal Tendons are enclosed in a common sheath while in the 

 groove directly behind the External Malleolus, but above and below this point, 

 the sheath is bifurcated: the upper bifurcation lies under cover of the Superior 

 Peroneal Band and the lower bifurcation comes into relation with the posterior 

 border of the Inferior Peroneal Band. The upper end of the sheath enclosing the 

 Long Peroneal Muscle, extends 1^/4 inches above the tip of the Malleolus; the 

 sheath for the Short Peroneal to a less height. The lower end of the sheath of 

 the Short Peroneal Muscle extends to Chopart's Joint but the sheath of the Long 

 Peroneal passes beyond as far as the groove on the Cuboid Bone, here it receives 

 a new sheath which comes almost into contact with the first sheath; a communi- 

 cation between them never occurs. Nevertheless, the intervening septum is so 

 thin that it is easil}' perforated by pus. 



By this route an Abscess of the sole of the foot may easily spread up 

 into the leg. Again; the relation of the Peroneal Sheaths to Chopart's Joint allows, 

 for example, tuberculosis of this joint to extend up the leg after perforating the 

 tendon sheaths. 



At the Ankle such easy means for extension are not found, although the 

 Tendons are closely applied to the joint behind the External Malleolus. The 

 reason of this is explained by the definite separation which the strong Calcaneo- 

 Scaphoid Ligament secures. 



