1 66 RESECTION OF THE LATERAL CARTILAGE. 



to the laminae and then backward from the coronary papillae 

 and keraphyllotis tissue. After the coronary band has been 

 smoothed vvitli the scissors, make two perpendicular incis- 

 ions through the skin of the coronary band and the band 

 itself, one behind the anterior and the other in front of the 

 posterior border of the groove in the horn and connect the 

 two by means of a semi-circular incision in the sensitive 

 laminae. This U-shaped incision must be so made that be- 

 tween it and the horny wall there is left an area of sensitive 

 laminae at least 2 cm. wide, in order that there may be suffi- 

 cient room in the soft tissues for the application of the su- 

 tures, as shown in Fig 2. The isolated flap is now dis- 

 sected closely against the os pedis and its ala and later from 

 the lateral surface of the cartilage, the operator first lifting 

 the flap with forceps, later with the hand. Above the carti- 

 lage toward the fetlock the operator must keep the fingers 

 of one hand against the external skin in order to avoid cut- 

 ting through it or thinning it too much at this point. The 

 flap is held turned upwards by an assistant or by a suture. 

 As a rule there is now seen a prominent, greenish colored 

 necrotic piece of cartilage surrounded by brownish red 

 masses of granulations. By means of an incision through 

 the cartilage parallel to the axis of the foot, divide it into 

 anterior and posterior halves and extirpate the latter first, 

 by dissecting it out on the inner side from the parachondrial 

 tissue with the double-edged sage knife. The point of the 

 knife must be constantly directed against the cartilage. 

 Since the inner surface of the anterior half of the cartilage 

 lies immediately against the capsular ligament of thecorono- 

 pedal articulation the latter should be sharply extended by 

 which means the capsular ligament is drawn away from the 

 cartilage during its extirpation. The anterior half of the 

 cartilage, k, is then removed in the same way, except with 

 the greatest possible care to avoid puncturing the corono- 

 pedal articulation. Remnants of cartilage at its juncture 



