AMPUTATION OF THE CLAW OR OF THE TWO LAST PHALANGES. 733 



The region is first shaved and thoroughly cleansed. The coronary 

 band of the claw is also preserved in this case. 



First stage. The horn below the coronary band is thoroughly 

 thinned and the tissues are divided as far as the bone. 



Second stage. The skin covering the front of the limb is vertically 

 incised from the lower third of the first phalanx (Fig. 298) to the 

 coronary band ; the skin is separated and external and internal flaps 

 are formed. 



Third stage. The extensor pedis tendon is divided, the first 

 inter-phalangeal joint opened, the internal and external lateral liga- 

 ments are divided, the claw is pressed backwards, and the flexor 

 tendons are also divided. 



To facilitate disarticulation, and particularly to facilitate section of 

 the lateral ligaments, the claw is rotated successively outwards and 

 inwards. 



According to circumstances, the lower extremity of the first 

 phalange is either scraped or divided and the stumps of the tendons 

 are carefully trimmed to a regular shape. 



A surgical antiseptic dressing is applied over the whole of the 

 seat of operation. 



Several other methods of performing this operation will be found 

 in Moller and Dollar's " Regional Surgery," pp. 831 — 835. 



