Tube foot

“ The foot is attached to the leg piece by a bolt made as follows: a steel tube fitting into two corresponding grooves in the leg and foot, is attached to the leg by being prolonged upward into a vertical rod, which is secured by a nut inside the leg piece. ”

“ The way of their prevention is already made plain, but to remove the disfigurement after it has become a settled thing is a much more difficult matter. The toe must be forced back to its former position, and kept there by a steady, constant pressure, and the parts be allowed time to gradually re-adapt themselves and grow fixed in their proper shape. The straightening of the toe will allow the bones to come nearer together at the joint, and this, when not sore, may perhaps be pushed back slightly, toward the middle of the foot, by the pressure of a narrow boot. ”

“ When the eversion is more pronounced, the sole looks laterally and the tendons of the peronei stand out in relief. The anterior part of the foot is displaced laterally. Flat-foot is frequently associated with stiff great toe; the patient having lost the power of dorsiflexing the toe, the first phalanx and first metatarsal are in a straight line, instead of forming an angle open towards the dorsum.
The muscles of the leg are flabby and poorly developed. ”

“ The feet are usually cold and sweat excessively. The gait is slouching, and there is a want of spring and elasticity. The lengthening of the foot results in the tendons, especially the flexors, being too short, hence hammer-like contraction of the toes may be brought about. The boots, after being worn, show a bulging of the instep towards the sole, greater wearing away of the sole along the medial border, and, when there is stiff great toe, an absence of the transverse crease on the dorsum opposite the balls of the toes. Footprints may be obtained by wetting the soles of the feet. ”

“ Raising the toe by means of a tip, a full shoe with thinned branches or a toe-calk, or paring away the quarters will tilt the os pedis backward, break the foot-axis backward in the pedal joint and to a less extent in the coronary joint, and increase the tension of the perforans tendon considerably and of the perforatus slightly. These tendons tightening behind the fetlock-joint force it forward, causing the long pastern to stand steeper, and taking some strain from the suspensory ligament. ”

“ The foot must be restored and held in its normal position and measures must be adopted to quiet local irritability or inflammation, and to strengthen the muscles. The best treatment does not consist in the permanent wearing of a flat-foot support; the support should be regarded in the same light as one uses a crutch in a fracture of the leg.
As a preliminary to all treatment, the use of proper shoes must be insisted upon. A shoe should be as wide in front, as the unshod foot, when bearing the weight of the body. ”

“ A waterproof top boot, so devised as to leave a fairly wide air space between the boot and the greater part of the foot, ankle, and lower part of the leg, would be more efficient and probably more convenient, provided the material used was soft and light, and did not interfere with movements. ”

“ With the bar removed, the outward movements of the frog under pressure are naturally rendered of no account, and a proper and intermittent expansion of the wall denied it. The same evil follows, though to a less extent, excessive paring of the sole.
The shape of the bearing surface of the shoe is often to be blamed. Where this is concave—'seated'—and the 'seating' is carried back to the heels, it is easy to see that, when weight is on the foot, there is an ever-present tendency for the bearing edge of the wall to slide down towards the inner edge of the shoe. ”

“ In founder or chronic laminitis, where the sole of feet are dropped, caused by the displacement of the weight-bearing bones of the foot, fix the feet by lowering the quarters and heels so as to get as much frog pressure as is possible, without making the foot tender, and your foot is ready for the shoe. A shoe for a dropped sole foot must be a bar shoe, thick at the toe and thin at the heels, with a wide thin bar to receive the frog pressure. ”

“ In order to attain this, the higher classes bind tight bandages round the feet of female infants, so that none but the great toe is suffered to retain its natural position. This compression is continued until the foot ceases to grow. It is then a misshapen little stump, four or five inches long, with all the smaller toes adhering firmly to the sole. The growth thus cruelly checked in its proper place, increases the ankle to such a clumsy size, that it almost entirely conceals the foot. ”

“ This joint is formed by a polished glass ball plying in a socket of vulcanite, the foot and ankle being joined together with four tendons, passing through rubber springs in the ankle; this joint admits of every motion the natural ankle has. In walking on the side of a hill or inclined plane, or where the foot is used to brace the body, the ankle flexes laterally and the foot remains flat on the ground, thus giving a firm base of support. ”

“ Now, such is the mutual static interdependence of the component parts of the lower limb that this condition of flatfoot promotes or favours the incidence of villous overgrowths in the proximal joints, the knees. As to the modus operandi we have put forward the following explanation: “The everted foot, with its sunken arch, as before stated, determines an alteration in the normal coaptation of the articular surfaces in the knee, and this incongruence is revealed in skiagraphs by the marked prominence laterally of the external tibial tuberosity beneath the external femoral condyle. ”

“ Then it is just such a shoe as would fit easily and comfortably a foot that treads outside; and for that very reason it is exactly such a one as ought to be worn by a foot that treads inwardly. All the force exerted by the stiffness of the counter, and the inclination of the whole shoe, goes toward righting up the foot and pushing it over outwardly. Still there is nothing that can hurt the foot—only a steady and gentle pressure in the right direction, which does not interfere with the use of the muscles. ”

“ No. 260. Some changes have been made in the ankle joint, but the notable modifications are a foot with thick sponge-rubber removable sole, K-K, in place of the rubber-covered core; for thigh amputations an adjustable steel knee cord and spring piston, combined in one piece, E, and knee-joint tightener, A.
The removable sole gives us an opportunity of strengthening the upper part of foot with a rawhide covering. Between the wooden part J and the rubber K at the toe part, layers of canvas and sole leather are placed to prevent breaking or turning up of the toe. ”

“ While a toe or two, or a small longitudinal segment of the foot, may be comparatively useless, and a good artificial foot, with an ankle-joint stump, certainly preferable, a single finger, provided its motions are tolerably intact, will prove much more valuable to its possessor than the most ingeniously contrived artificial hand. ”