SUPERCARPAL TENOTOMY 123 



radius and large metacarpal bone would, if produced, meet at an obtuse 



angle the apex of which would be directed forwards and be placed 

 about the middle of the knee. 



SUPERCARPAL TENOTOMY 



As a method of treatment of contraction of these tendons, particu- 

 larly where such contraction is due to congenital malformation, the 

 operation of dividing one or both tendons is performed in order that the 

 limb may be straightened. To this operation the name Supercarpal 

 Tenotomy is given. 



In order to perform this operation, the animal should be cast, and the 

 knee extended as much as possible by pulling the forearm backwards 

 and the metacarpal bone forwards. This will bring the tendons of the 

 flexors into greater prominence. In operating on the tendon of the 

 external flexor a small cutaneous incision should be made in front 

 of the tendon about three inches above the radio-carpal articulation. 

 The adoption ot such a seat will enable the operator to sever the 

 tendon at a position which is superior to its point of bifurcation, and 

 there will also be no danger of injuring the artery, which passes 

 beneath the tendon a little lower down, or of opening the carpal 

 sheath, since the incision is above the latter's upper limit. This 

 incision should only be of sufficient size to admit the tenotome, since 

 it is unnecessary to expose the tendon by bringing it out through the 

 cutaneous opening. 



A curved tenotome should now be introduced through the cutaneous 

 incision and pushed transversely behind the tendon and between it and 

 the skin, the instrument being disposed with its flat surface directed 

 toward the tendon. The blade is next turned so that its concave or 

 cutting edge embraces the tendon, and the tendon is severed by cutting 

 through it in an oblique direction upwards and forwards. The assistants 



