Pan-arthrodesis for paralytic flail foot.

Paralysis of all the foot motors is rare as an isolated phenomenon, but it is common in conjunction with paralysis of other muscle groups in the lower limb. If one muscle remains active, it is usually the short flexor of the toes. The foot looks narrow, like a ‘ ‘ midwife’s hand.” It is flaccid and, when bearing weight, is held at right angles to the leg, with a tendency to calcaneus; when not bearing weight, it hangs in equinus. There are always pronounced trophic and vaso-motor changes. The feet are cold and cyanosed, with chilblains in winter, especially on the toes and above the ankle on the posterior aspect of the leg. The scars of these may be visible. The victims are “ slaves to their feet,” which are a source of much misery, and may be found protected against pressure by adhesive strapping, cotton wool or bandages.