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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1769 Excerpt: ...fibula, or os calcis, have their natural direction and disposition so altered, that instead of performing their appointed actions, they all contri bute 4 bute to the distortion of the foot, and that by turning it outward and upward. When this accident is accompanied, as it sometimes is, with a wound of the integuments of the inner ancle, and that made by the protrusion of the bone, it not infrequently ends in a fatal gangrene, unless prevented by timely amputation, though I have several times seen it do very well without. But in its most simple state, unaccompanied with any wound, it is extremely troublesome to put to rights, still more so to keep it in order, and unless managed with address and skill, is very frequently productive both of lameness and deformity ever after. After what has been said, a farther explanation why this is so is unnecessary. Whoever will take even a cursory view of the disposition of the parts, will see that it must be so. By the fracture of the fibula, the dilatation of the bursal ligament of the joint, and the rupture of those which mould tie the end of the tibia firmly to the astragalus and os calcis, the perpendicular bearing of the tibia on the astragalus is lost, and the foot becomes distorted; by this distortion the direction and action of all the %iuscles already recited are so altered, that it becomesbecomes (in the usual way of treating this case) a difficult matter to reduce the joint, and, the support of the fibula being gone, a more difficult one to keep it in its place after reduction. If it be attempted with compress and strict bandage, the consequence often is a very troublesome as well as painful ulceration of the inner ancle, which very ulceration becomes itself a reason why such kind of pressure and bandage can ...

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