S68 TENOTOMY. 



to the middle portion of the flexor perforatus tendon. By this free 

 incision, though not through the theca, the operator will be able to 

 stretch the mouth of the wound he has made round to the inner 

 side of the leg; in which stretched position the skin is to be held 

 by an assistant, while the operator introduces the fore finger of 

 his left hand to push back the bloodvessels and nerve (which run 

 along the inner borders of the tendons) against the suspensory 

 ligament, so that they be safe out of the way, while with the right 

 hand he insinuates his bistoury between them and the flexor ten- 

 dons. Opposing, now, the cutting edge of the bistoury to the 

 tendons themselves, he commences incising them by a steady but 

 firm and strong sawing movement, until both be completely divided. 

 I say, he is to hold the bistoury — ^which ought to be a stout one — 

 firmly, and to use it with some force, since such is the dense and 

 tough texture of these tendons that they are not cut completely 

 through without some determination. Complete division being 

 made of them, the heel of the foot still will not come down — 

 should it happen, as I believe sometimes it does, that the meta- 

 carpal ligamentj running in front of the tendo perforans — has not 

 been included in the section. If it now be required, we may use 

 such force as will make the limb straight, by stretching or even tear- 

 ing through adhesions of moderate standing, so far as this can be 

 effected without the risk of rupturing ligament or fracturing bone. 

 The giving way of adhesions, in such cases, is frequently attended 

 with a sort of snap or jerk, denotive of their being overcome, and 

 by this the end is known to be answered : such adhesions and im- 

 pediments to extension being commonly situate about or in the 

 vicinity of the fetlock joint. The usual, but a dangerous, mode of 

 accomplishing the extension, is to place the knee against the front 

 of the fetlock, and, grasping the back of the foot with one hand and 

 the upper end of the leg with the other, to use such steady and mode- 

 rate force as will accomplish the object. This done, the divided ends 

 of the tendons recede from each other, leaving a gap between them 

 of one or two inches, or even more, dependent upon circumstances*. 



• Mr. Cooper in The Veterinarian ior June 1850, suggests division of the 

 metacarpal ligament only. How far this might answer the end desired I can- 

 not at present say. 



