4. Talipes Calcaneus.
—In this deformity the anterior part of the foot is drawn upward by its anterior flexors and a little to the outer side, while the sural muscles are relaxed; thus the patient walks upon the heel. The condition is often more or less combined with talipes valgus. It is rarely of congenital origin, but is generally due to paralysis of the distal muscles following injury or poliomyelitis. It is sometimes of hysterical origin, and it may occur as the result of muscle spasm following bone or joint disease ([Fig. 266]).
Fig. 266
Fig. 267
Talipes calcaneus.
Pes cavus, hollow clawfoot.
Those forms due to infantile paralysis are to be treated mainly by tendon grafting or some similar expedient, and this to be followed by a suitable shoe containing a sole plate with an upright attachment and a joint opposite the ankle. Other forms must be treated, each on its own merits, but according to general principles already enunciated.