OPERATIONS FOR STRINGHALT. 1025 



Treatment. The operation which has proved most generally suc- 

 cessful in idiopathic stringhalt is peroneal tenotomy. It has one 

 qualification — that, namely, of being easily performed. The operation 

 may be performed in the standing position ; the procedure is as 

 follows : — 



The hind foot is lifted as in shoeing, and the hair having been 

 shaved from an area close below the hock, on the outer surface of 

 the metatarsus, where the peroneus tendon joins the extensor pedis 

 and is almost subcutaneous, the skin is washed and rinsed with carbolic 

 solution. A twitch is then applied, and an incision made with a 

 bistoury or scalpel, immediately over the tendon and parallel to it. 

 To penetrate the fascia lying under the skin, the point of the knife 

 is carried right into the tendon. A slender blunt-pointed tenotome 

 is then passed under the tendon, i.e., between it and the bone, and 

 the cutting edge being directed outwards, the tendon is subcutaneously 

 divided. Excision of a portion of the tendon is of no advantage, 

 and delays healing. Palpation of the parts will show whether section 

 is complete. Bleeding being usually slight, the wound may be rinsed 

 with a disinfectant, sutured, and a dressing at once applied, under 

 which healing will in four to five days be so far advanced as to allow 

 of the wound being left uncovered. If the instruments, operator's 

 hands, and dressings be sterile, early healing results ; and even when 

 suppuration occurs, though the point of operation is left somewhat 

 thickened, no further ill-effect is incurred. Complete recovery from 

 stringhalt may follow peroneal tenotomy either at once, or be post- 

 poned for some days, or there may be no improvement. Defective 

 extension of the pastern may follow operation and require the appli- 

 cation of a sideline to hold the foot in proper position for a few days. 



The animal should be rested for eight to fourteen days after 

 operation, and then turned loose in a box, or moved slowly on soft 

 ground. 



Moller several times divided the aponeurosis which covers the 

 peroneus and extensor pedis tendons (Dieckerhoff's method) whilst 

 the animal was standing, but restless horses should be cast for either 

 operation. After section of the peroneus, the tenotome is passed 

 under the fascia, which is divided from within outwards, care being 

 taken to avoid wounding the extensor pedis tendon, or artery of 

 the cannon. The after-treatment is as above stated. Practising 

 this method, Wolff has had several successful results. 



Hertwig recommended cutting through the tensor vagina? femoris, 

 about 3 or 4 inches below the external angle of the ilium. This 

 operation is more difficult, and is often followed by formation of pus, 



R.S. 3 U 



