1. Twenty-three cases of tarsal anomalyâtalo-calcaneal bridge or calcaneo-navicular barâoccurring among thirty cases of "peroneal spastic flat foot" have been studied. 2. The correlation between the clinical features and the mechanical defect is discussed.
1. Radiological investigation of cases of flat foot shows that they form three distinct anatomical types according to the precise level of the break in the arch. 2. When the break occurs at the naviculo-cuneiform joint alone, fusion of this joint in normal alignment should correct the deformity. 3. The results of operation on forty-six feet are analysed. Eighty-two per cent proved satisfactory. Failures are discussed and are considered avoidable by careful selection and operative technique.
Rupture of a ligament usually occurs along a definite line, but is associated with considerable intrinsic damage to the remote parts of the ligament. In spite of this, healing occurs by regeneration of regular collagen to form a new ligament with good tensile strength, provided the ends of the torn ligament are in reasonable apposition, and provided the blood supply is adequate. When lateral instability of the knee after a recent injury suggests that a collateral ligament has been ruptured, wide displacement of the torn ends should be suspected. Accurate replacement can be guaranteed only by surgical intervention; operative repair therefore seems to be justifiable on anatomical grounds. If operation is contemplated it should be undertaken within the first week after injury when it is easy to achieve accurate repair, which later becomes impossible because of shrinkage and friability of the tissue. In order to preserve blood supply, the areolar covering should be disturbed as little as possible, and the least possible amount of fine suture material should be used to anchor the torn ends in position. Nevertheless when the tear involves the upper attachment, ischaemia of the damaged ligament may prevent normal healing, whatever the treatment adopted.