Orthopedics of childhood / by Willis C. Campbell.

  • Campbell, Willis C. (Willis Cohoon), 1880-1941.
Date:
1927
Catalogue details

Licence: In copyright

Credit: Orthopedics of childhood / by Willis C. Campbell. Source: Wellcome Collection.

    46/352 (page 12)
    Fig. ii.—Normal Posture Showing Dis¬ tribution of Weight on Feet and Ankles. THE FOOT AND ANKLE Inspection.—The distribution of weight-hearing on the feet, or any abnormality in contour, is noticed. The patient then walks, when any limp or peculiarity in gait becomes apparent. Passive motion of the foot and ankle is elicited by grasping the forefoot and moving the ankle and foot as far as possible in dorsiflex- ion, extension or plantar flexion, abduction, and adduction. If the normal range is known, any restric¬ tion is apparent. Passive motion of the foot alone is carried out by grasping the heel and forefoot, thereby demonstrating movements in the midtarsal and subastragalar joints. Motion in the toes and smaller joints is obviously too simple to warrant description. As deformity is more frequent in the feet than elsewhere from the loss of muscle balance, active motion is most im¬ portant to ascertain muscle power. The range of active motion can be ascertained by observing the move¬ ments of any normal child. X-Ray.—The x-ray of the foot and ankle requires two views of the ankle and two of the foot. THE KNEE Inspection.—As the knee is superficial, slight abnormalities are apparent by obliteration of bony landmarks from effusion within, periarticular swell¬ ing, or changes in position and contour. A comparison with the opposite knee facilitates differentiation. There are only two movements to be con¬ sidered in the examination of the knee: flexion and extension. Flexion is possible until the calf of the leg approximates the posterior aspect of the thigh. Extension begins when the leg is fully flexed, and is completed when the leg forms a straight line with the thigh. A line drawn from the anterior superior spinous process to the great toe should pass through the