ver, that in young patients growth is stimulated by walking on the
limb after the deformity has been corrected; the sole of the boot is
then raised to the necessary extent.

#Pes Calcaneus.#--In this deformity the foot is dorsiflexed at the
ankle-joint. It is sometimes combined with eversion of the foot--_pes
calcaneo-valgus_, or with inversion--_pes calcaneo-varus_.

Pes calcaneus may be congenital or acquired. In the _congenital form_
the deformity is frequently bilateral. There is dorsiflexion at the
ankle-joint, and if an attempt is made to flex the foot towards the
sole, the extensor tendons stand out prominently. In marked cases the
long axis of the calcaneus is vertical, the tendo Achillis lies in
close contact with the tibia, and the hollows on either side of the
tendon are absent. The peronei are displaced from their grooves, and
may lie in front of the lateral malleolus.

Corrective manipulations are commenced within a few days after birth,
and a malleable splint is worn between times. When the child begins to
walk there is a natural tendency towards recovery. In severe cases it
may be necessary to lengthen the contracted tendons--the extensor
digitorum, the extensor hallucis, and, it may be also, the peroneus
tertius and tibialis anterior; the tendo Achillis may require to be
shortened.

In the _acquired form_, the appearances are different, because the
anterior part of the foot is usually flexed towards the sole, thus
disguising to a certain extent the dorsiflexion at the ankle. This
form is nearly always due to poliomyelitis, but it may also result
from accidental division of the tendo Achillis. The anterior part of
the foot is flexed towards the sole by the contraction of the plantar
fascia and short muscles of the sole, the balls of the toes are
approximated to the heel, and a deep transverse groove is formed in
the sole opposite the mid-tarsal joint. The deformity presents a
combination of the hollow foot--pes cavus--with pes calcaneus, and
resembles that of a Chinese lady's foot. The foot rests on the heel
and on the balls of the great and little toes, the sole of the foot
being so deeply hollowed that even the lateral border does not touch
the ground.

In paralysis of the calf muscles alone, the tendons of the peronei or
flexor digitorum longus may be divided and stitched to the calcaneus,
to take the place of the tendo Achillis. If the calf muscles are not
completely paralysed and the tendo Achi