Henry Gray (18251861). Anatomy of the Human Body. 1918.
The lateral condyle is more easily felt than the medial; both epicondyles can be readily identified, and at the upper part of the medial condyle the sharp adductor tubercle can be recognized without difficulty. When the knee is flexed a portion of the patellar surface is uncovered and is palpable.
The anterior surface of the patella is subcutaneous. When the knee is extended the medial border of the bone is a little more prominent than the lateral, and if the Quadriceps femoris be relaxed the bone can be moved from side to side. When the joint is flexed the patella recedes into the hollow between the condyles of the femur and the upper end of the tibia, and becomes firmly applied to the femur.
A considerable portion of the tibia is subcutaneous. At the upper end the condyles can be felt just below the knee; the medial condyle is broad and smooth, and merges into the subcutaneous surface of the body below; the lateral is narrower and more prominent, and on it, about midway between the apex of the patella and the head of the fibula, is the tubercle for the attachment of the iliotibial band. In front of the upper end of the bone, between the condyles, is an oval eminence, the tuberosity, which is continuous below with the anterior crest of the bone. This crest can be identified in the upper two-thirds of its extent as a flexuous ridge, but in the lower third it disappears and the bone is concealed by the tendons of the muscles on the front of the leg. Medial to the anterior crest is the broad surface, slightly encroached on by muscles in front and behind. The medial malleolus forms a broad prominence, situated at a higher level and somewhat farther forward than the lateral malleolus; it overhangs the medial border of the arch of the foot; its anterior border is nearly straight, its posterior presents a sharp edge which forms the medial margin of the groove for the tendon of Tibialis posterior.
The only subcutaneous parts of the fibula are the head, the lower part of the body, and the lateral malleolus. The head lies behind and lateral to the lateral condyle of the tibia, and presents as a small prominent pyramidal eminence slightly above the level of the tibial tuberosity; its position can be readily located by following downward the tendon of Biceps femoris. The lateral malleolus is a narrow elongated prominence, from which the lower third or half of the lateral surface of the body of the bone can be traced upward.
On the dorsum of the tarsus the individual bones cannot be distinguished, with the exception of the head of the talus, which forms a rounded projection in front of the ankle-joint when the foot is forcibly extended. The whole dorsal surface of the foot has a smooth convex outline, the summit of which is the ridge formed by the head of the talus, the navicular, the second cuneiform, and the second metatarsal bone; from this it inclines gradually lateralward, and rapidly medialward. On the medial side of the foot the medial process of the tuberosity of the calcaneus and the ridge separating the posterior from the medial surface of the bone are distinguishable; in front of this, and below the medial malleolus, is the sustentaculum tali. The tuberosity of the navicular is palpable about 2.5 to 3 cm. in front of the medial malleolus.
Farther forward, the ridge formed by the base of the first metatarsal bone can be obscurely felt, and from this the body of the bone can be traced to the expanded head; beneath the base of the first phalanx is the medial sesamoid bone. On the lateral side of the foot the most posterior bony point is the lateral process of the tuberosity of the calcaneus, with the ridge separating the posterior from the lateral surface of the bone. In front of this the greater part of the lateral surface of the calcaneus is subcutaneous; on it, below and in front of the lateral malleolus, the trochlear process, when present, can be felt. Farther forward the base of the fifth metatarsal bone is prominent, and from it the body and expanded head can be traced.
As in the case of the metacarpals, the dorsal surfaces of the metatarsal bones