316 OPERATIONS ON MUSCLES AND THEIR ANNEXES. 



Fig. 329.- Straight Tenotomy Knife. 



Fig. 330.— Curved Tenotomy Knife. 



the latter narrow, curved and blunt, and sharp on its concave 

 edge. 



The ammal being prepared, a puncture of the skin is made over 

 the tendinous region (carefully avoiding the synovial sacs, as men- 

 tioned above), by introducing the straight tenotome perpendicu- 

 larly between the tendons, until the point of the instrument is felt 

 on the opposite side of the leg. A slight sawing motion of the 

 instrument then cuts through the connective tissue which unites 

 them, and permits the introduction of the cui'ved tenotome into 

 the tract made by the straight instrument, and the latter is slowly 

 withdrawn. At this point the leg is carried into excessive exten- 

 sion by the assistants, by means of ropes secured resiDectively, 

 one about the knee, and one about the foot, and pulling that of the 

 knee backward and that of the foot forward. The fetlock being 

 thus stretched to its utmost, the oj)erator, with the edge of the 

 curved tenotome turned toward the deep flexor, makes a slight 

 sawing motion with the instrument, and cuts through the fibrous 

 structure from behind and forward, a peculiar crackling sound in- 

 dicating when the sectionis accomplished. The retracted extrem- 

 ities of the tendons can now be felt with a wide interval between 

 them, and the straightening, more or less, of the fetlock gives fur- 

 ther proof that the operation is completed. 



This is the method in simple tenotomy. Some operators have 

 suggested the introduction of the instrument between the sus- 

 pensory ligaments aijd the perf orans in preference to the mode we 

 have described, in which case the section of the tendon must be 

 made from before backward. It is, however, a complicated pro- 

 cess, and one which is not without danger of injuring tissues 

 which ought to be left intact. The mode of ojDerating known as 

 the Bernard method is based on this principle. 



The double tenotomy, though considered at first as a severe 



