324 



OPERATIONS ON MUSCLES AND THEIR ANNEXES. 



border of tlie trochlea of that bone, and passes in the groove 

 situated between the anterior and external tuberosity of the 

 superior extremity of the tibia, do^vTiward to the hock, where it 

 rests on the anterior face of that joint and is attached by two 

 branches, one to the cuboid, on the outside of the hock, the other 

 to the superior extremity of the principal metatarsal bone. The 

 muscular portion, which rests on the external face of the tibia, 

 from the upper part of which it takes its origin, terminates in- 

 feriorly by a tendon which passes through a ring of the tendinous 

 portion, and becomes more superficial, and then divides into two 

 branches, a large one, which goes to the superior part of the 

 princii^al metatarsal bone, in uniting with that of the tendinous 

 portion, and another, smaller, which bends inward, to terminate 

 at the small cuneiform bone. This branch is chosen as the seat 

 of operation. 



The operation recommended by Abildgaard and Viborg, was 

 indicated by Hertwig, and at a later period performed by Lafosse, 

 Hering, Mantel, Grad, Bugniet and Dieckerhoff. It is very com- 

 monly performed on this continent, and, 

 like many other operations at the time 

 of their first introduction, has been both 

 used and probably abused to such an ex- 

 tent that it has not yet received the credit 

 to which it is fairly entitled. 



It is indicated for the relief of the pres- 

 sure which this branch makes upon the 

 distended periosteum of the enlarged tar- 

 sal exostoses known as s^^avins, and when 

 the exostosis is, strictly speaking, the only 

 lesion in the hock, it will prove essen- 

 tially beneficial. But if, with the new 

 growth of bony deposits, the joint itself 

 Fig. 337.— cunean Branch of the should be involved, and some of the ar- 



Flexor Metatarsi. ^.^^^^^^. ^gg^ggg gj^Q^^j^j ^^ present, the 



result, so far as the removal of pain and lameness is concerned, 

 is not always certain. Although more or less satisfactory at times, 

 in many instances it entirely fails. The difficulty of positively 

 diagnosing the condition of the articular surfaces justifies the 

 surgeon in operating, when the tense condition of the tendon, its 

 pressure upon the exostosis, and the irritation of the synovial sac 



