OPERATIONS OX THE FOOT 97 



the internal metacarpal vein run down the limb in close 

 proximity with the inner border of the flexor tendons. Also, 

 we remember that the external plantar nerve has no atten- 

 dant artery, although, like its fellow, it is to be found in 

 close touch with the edge of the flexor tendons. 



Bearing these landmarks in mind, we feel for the nerve 

 in the hollow just above the fetlock-joint by noting the 

 pulsations of the artery, and determining the edge of the 

 flexor tendons. This done, a clean incision is made with 

 the bistoury or the scalpel in the direction of the vessel. 

 Ihe incision should be made firmly and decisively, so that 

 the skin may be cleanly penetrated w T ith one clear cut. If 

 judiciously made, little else in the shape of dissection will 

 be needed. 



It is now r that the double tenaculum (Fig. 61) is applied. 



Fig. 61. — Double Tenaculum. 



One clip is fixed to the anterior edge of the wound, and the 

 other carried beneath the limb and made to grasp the 

 posterior edge. If found desirable to keep the edges of the 

 wound apart, and no tenaculum to hand, the same end may 

 be accomplished by means of a needle and silk. In like 

 manner as is the tenaculum, the silk is attached to one edge 

 of the wound, carried under the limb, and firmly secured to 

 the other. 



Having made the incision, the wound should be wiped 

 free from blood by means of a pledget of cotton-wool 

 previously soaked in a carbolic acid solution and squeezed 

 dry. At the bottom of the wound will now be seen the 

 glistening white sheath, containing the vein, artery, and 

 nerve. This should be picked up with the forceps, and a 

 further incision made with the bistoury. Care should be 

 exercised in making this second incision, or the artery may 



