TENOTOMY. 367 



pending on circumstances, sometimes apparent, sometimes unfore- 

 seen and unavoidable, attending the operation. I will now produce 

 a case in illustration of an incidental mishap which all under- 

 takers of this bold operation must calculate beforehand the proba- 

 bilities or improbabilities of meeting with ; and I do this in order 

 that practitioners may in their minds be prepared for such-like 

 unwelcome occurrences and results. 



Mr. Goodenough, V.S., Driffield, divided the flexor tendons for 

 " contraction" in the usual way. But, after he had so done, he 

 found he could not force the bent leg back into its straight or 

 proper position*. He fastened halters to the refractory limb, and 

 employed four men to exert their strength in its extension. At 

 the moment of their utmost efforts " a loud crack was heard," 

 which frightened the men and surprised the operator. A few days 

 were allowed to pass, when, no hopes whatever appearing of re- 

 covery, the horse was destroyed. It was found that the sesamoid 

 bones had contracted adhesions to the metacarpal bone, and that 

 these (adhesions) had sustained the force used for extension, while 

 the sesamoids had become thereby fractured in twain. 



The Operation of Tenotomy, though a formidable one for 

 the patient, is not a difficult one for the operator. The object con- 

 sists in section of the flexor tendons; the effect of which, as we 

 have seen, is to let down the heel of the foot (not the fetlock) to 

 the ground. The flexor tendons, aided by the metacarpal ligament, 

 support the pastern and foot joints principally; the fetlock joint 

 having the additional strong support of the suspensory ligament, 

 which it still retains after the tendons have been cut through. This 

 accounts for the heel of the foot, without the fetlock, being let down 

 by the operation of tenotomy. 



Having cast the horse, and so secured the limb to be operated 

 on that there is not much chance of any interruption being occa- 

 sioned through its motion, a longitudinal incision, about an inch in 

 length, is made on the inner side, along the course of the flexor 

 tendons, midway between the knee and fetlock ; though I have 

 myself commenced by an incision along the back of the leg, opposite 



* This, it is possible, might have been owing to the metacarpal ligament 

 being left undivided. 



