170 



HEALTH AND DISEASE 



After making a very small incision in the skin, the leg is slightly flexed. 

 The tenotomy knife (fig. 514) is then forced sideways between the tendons 

 and the suspensory ligament. The point of the knife must not be allowed 

 to puncture the skin on the opposite side of the limb, and when introduced 

 it must be kept close to the tendons to avoid injury to the vessels and 

 nerves running along their border. The blade is now turned so that the 



cutting edge is brought 

 into contact with the part 

 to be divided; the foot is 

 then forcibly extended by 

 an assistant acting on 

 the foot rope, and by 

 a firm, steady, sawing 

 movement of the knife 

 the tendon is severed. 

 This will be made known 

 by a sharp snapping noise 

 emitted by the sudden 

 parting of the divided 

 portions. The operation 

 being accomplished, the 

 knife is withdrawn and 

 the animal is allowed to 

 rise. A piece of carbo- 

 lized wool is now applied 

 to the wound, and sup- 

 port given to the leg by 

 the application of a linen 

 bandage from the foot 

 upward towards the hock 

 or knee, as the case may 



be. In order to prevent any undue lengthening of the divided tendons 

 during reparation a high-heeled or a patten shoe will require to be placed 

 on the foot, and the animal must be supported by slings. At the expira- 

 tion of a fortnight or three weeks the heel of the shoe must be lowered, and 

 the position the foot takes on the ground carefully noted from day to day, 

 so that should the heel show any signs of being drawn up as the tendon 

 becomes reunited, a shoe with a long toe-piece or lever must be fitted to 

 the foot in order to prevent undue contraction in the uniting substance. 



It is customary with some to divide both perforans and perforatus, but 

 in recent cases of contraction it suffices to divide the one or the other, 



Fig. 515. Tenotomy of the Perforans Tendon, showing position 

 of hands and knife 



