FREE BOOKS

Author's List




PREV.   NEXT  
|<   152   153   154   155   156   157   158   159   160   161   162   163   164   165   166   167   168   169   170   171   172   173   174   175   176  
177   178   179   180   181   182   183   184   185   186   187   188   189   190   191   192   193   194   195   196   197   198   199   200   201   >>   >|  
of the foot. Here the plantar aponeurosis, the navicular bursa, the navicular bone itself, or the pedal articulation may be injured. Anterior to this position the most serious mischief that can ordinarily result is stabbing of the os pedis. Posterior to the position we have named, the only structure to be injured is the plantar cushion. Anatomically, then, the inferior surface of the foot may be divided into three zones, as follows: _A. Anterior_, extending from the toe to the point of the frog. _B. Middle_, extending from the point of the frog to the commencement of its median lacuna. _C. Posterior_, including everything posterior to the middle zone. This division of the inferior surface of the foot into zones will be somewhat of a guide also when describing the complications next to follow: _(a) Suppuration_.--This is the common complication of most wounds of the foot. When detected, it calls for immediate surgical interference in the shape of removal of the horn of the sole or the frog, as the case may be. This we shall consider further under the treatment. _(b) Separation of the Horny Frog_.--This is a sequel to pus formation in the sensitive structures immediately beneath it, and the condition makes itself apparent by a line of separation between the horn and the skin of the heel of the injured side. _(c) Wounding of the Plantar Aponeurosis_.--This occurs when a moderately-deep penetration of the horn of the middle zone has taken place. It is always most painful, especially when complicated by necrosis. The heel is then persistently elevated, and lameness is extreme, in some cases so severe as to cause the leg to be carried altogether. In favourable cases the necrosed piece of tendon is sloughed off by the process of suppuration, and escapes with the discharges from the wound. There is then an abatement in the symptoms, and recovery is rapid. Commonly, however, on account of the non-vascularity of the structure of the tendon, the necrotic spot in it tends to spread. The wound is thus led to become fistulous in character, and the pus forming within it prevented from escaping from the original opening. As a result, lameness and fever persist. There is a gradual increase in the severity of the symptoms, and later fistulous openings appear in the hollow of the heel. _(d) Puncture of the Navicular Bursa_.--This results from a prick in exactly the same position as that last described, and means
PREV.   NEXT  
|<   152   153   154   155   156   157   158   159   160   161   162   163   164   165   166   167   168   169   170   171   172   173   174   175   176  
177   178   179   180   181   182   183   184   185   186   187   188   189   190   191   192   193   194   195   196   197   198   199   200   201   >>   >|  



Top keywords:

position

 
injured
 

surface

 
tendon
 
plantar
 

symptoms

 

navicular

 

inferior

 
middle
 
fistulous

extending
 

Posterior

 

result

 

structure

 

Anterior

 

lameness

 

penetration

 

sloughed

 
painful
 
discharges

suppuration

 

escapes

 

process

 

favourable

 

persistently

 

elevated

 
extreme
 
severe
 

necrosed

 
necrosis

altogether

 
carried
 

complicated

 
spread
 
openings
 

hollow

 
severity
 

increase

 

persist

 
gradual

Puncture

 

Navicular

 

results

 

opening

 

original

 

account

 
vascularity
 

necrotic

 

abatement

 

recovery