IV. OPERATIONS ON THE EXTREMITIES. 



33. TENOTOMY OF THE FLEXORS OF THE PHALANGES. 

 Plate XXIII. 



Objects. The relief of contraction of the flexor tendons 

 of the foot. 



Instruments. Razor, scissors, sharp tenotome, bandage 

 material. 



Technic. Tenotomy is generally performed on the 

 flexor of the third phalanx, seldom on the superficial flexor 

 or flexor of the .second phalanx. 



Confine upon the operating table with the affected 

 member undermost and the foot fully extended. In default 

 of a table confine in lateral recumbency and apply an exten- 

 sion splint to the foot as shown in Plate XXIII. 



On the median side at the middle of the metacarpus or 

 metatarsus the skin is shaved and disinfected over the 

 tendon of the flexor pedis muscle. The location named lies 

 between the lower extremity of the great carpal or tarsal 

 sheath above and the superior extremity of the tendonous 

 sheath of the fetlock below, .so that neither of these is 

 wounded during the operation, but the tendon is severed at 

 a point where it is invested by loose connective tissue which 

 retains the divided ends in their normal line of direction, 

 somewhat fixed, and favors their ultimate leunion. 



Grasp the metacarpus or metatarsus in this area from 

 above and behind in such a manner that the thumb rests 

 upon the median or upper surface, and the index and second 

 fingers on the lateral or under side of the flexor pedis 

 tendon. While the left thumb pushes the skin toward the 

 bone, that is, forward, a sharp pointed tenotome held perpen- 

 dicularly in the right hand is introduced with the cutting 

 edge toward the hoof through the skin, subcutem and anti- 

 brachial fascia down to the flexor pedis tendon. Immedi- 



