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Dislocations of the Bones of the Foot

dislocation and astragalus

DISLOCATIONS OF THE BONES OF THE FOOT.

Dislocation of a Tarsal the for mer dislocation the astragalus was separated from the bones of the leg, but it may retain its connection with the leg-bones and be separated from the other bones of, the foot, from the heel bone with which it is connected below, and from the scaphoid with which it unites in front.

The dislocation may be backwards or for wards (the latter very rare), outwards or in wards.

When dislocated backwards the foot is length ened behind, and the ankle-bone is forced on to the instep, and when outwards, the foot rests On the inner border, the outer being raised, and there is a projection inwards of the tibia with the astragalus in its grip. In the inward dis location of the foot, the fibula and astragalus form an outward projection, and the foot rests on the outer border, the inner being raised.

Treatment.--Fixing the leg-bones, pulling on the foot, and pressure exerted on the dis placed bones will usually reduce them. Some

times reduction is very difficult owing to wedg ing of the astragalus ; and cutting through of certain tendons may be necessary. The after treatment is the same as for other dislocations.

Dislocations of the Metatarsal Bones. These sometimes occur as the result of great violence. Extension, counter - extension, and manipulation, as described for dislocation of the tarsus, are the proper means of restoring the bones to their position.

Dislocations of the Bones of the Toes (Phalanges).--The bones of the toes are seldom displaced ; when they are, the displacement is upward, and is frequently combined with frac ture. The treatment is the same as for reduc tion of dislocated fingers, the apparatus figured on page 61 being specially necessary.