OPERATIONS UPON FIBROUS TISSUES. 321 



(e) Exaggeration of the Extension. — This may take place 

 ^hen artificial means to produce sudden extension are too power- 

 ful, or when the %iolent efforts of the animal have caused a ten- 

 dency in the parts to give way suddenly. The apparatus before 

 referred to must be here brought into requisition. 



(/) Return of the Original Deformity. — This results from 

 the retraction of the new tissue formed between the stumps of 

 the divided tendon. It occurs as a consequence of returning the 

 animal to his work at too early a date, and when the newly formed 

 tissvie has not yet become sufficiently matured and sohdified to 

 sustain the strain to which it had been subjected. Best, cold 

 water bathing in a running stream, vesicating applications and 

 firing have been recommended as remedies, and even a second 

 section of the tendon may be suggested, though with but a doubt- 

 ful prospect of good results. 



Carpal Tenotomy. 



This defines the section of the tendons of the external and 

 oblique flexor muscles of the metacarpus. They are inserted on 

 the trapezium bone of the carpus, and their retraction occasions 

 the deformity known as sprung knees, a condition brought on by 

 excessive and exhaustive labor, though there is a class of pa- 

 tients in which the lesion may be ascribed to a congenital taint, 

 and it is principally for the benefit of this class of patients that 

 the operation is indicated and usually performed. It is principally 

 favored and utilized in Germany, where it was originated hj 

 Dieterichs, though afterwards adopted and practiced by Prud- 

 homme, Lafosse, Miguel, Brogniez, Hering, Gourdon and others. 

 The operation can be performed on either tendon singly, or on 

 both ; but according to Hering, the division of the external mus- 

 cle is generally sirfficient. 



The anatomy of the region should be described before passing 

 to a detail of the steps by which the section of the tendon is ef- 

 fected. The external flexor is situated on the postei-ior external 

 part of the forearm, and terminates by the branches, one of which, 

 the funicular, is anterior, and passing in the groove of the external 

 face of the trapezium, becomes attached to the hand of the exter- 

 nal rudimentary metacarpal bone ; while the other posterior, wide 

 and short, goes to the supero and posterior circumference of the 

 same bone, in connection with the middle flexor, to which it is 



