128 THE SURGICAL ANATOMY OF THE HORSE 



in order that the cutting edge may be directed backwards and embrace 

 the perforatus tendon. 



The tendon is then divided from before backwards. This is a very 

 simple operation, as there is no danger of injuring the nerves and vessels. 

 The only precaution to be taken is to proceed slowly when completing 

 the section of the tendon, in order to preserve the skin behind the 

 tendon intact. 



TENOTOMY OF BOTH FLEXORS OF THE DIGIT 



In dividing both tendons the incision may be made in one or other 

 of the positions indicated in the two methods of performing tenotomy of 

 the perforans alone. If the incision is made in the position indicated in 

 the first method, the tenotome is introduced in front of the perforans 

 tendon and between it and the suspensory ligament, and the tendon is 

 severed by cutting from before backwards. Or the cutaneous incision 

 may be made and the tenotome introduced between the two tendons, 

 when, after severing the perforans in the manner already described, by 

 cutting forwards, the tenotome is turned completely round and the 

 perforatus severed by pressing the instrument backwards, keeping the 

 blunt extremity of the tenotome close to the skin, and thus causing it 

 to describe a curve. This will lessen the danger of cutting the skin. 



It should be observed that in performing this double tenotomy 

 particular attention should be devoted to dealing effectively with the 

 vessels and nerves. 



Some operators find it expedient to strap the limb to a firm splint 

 before performing tenotomy, the straps being so applied that the knee 

 is forcibly extended. This is a convenient method to adopt where 

 ample assistance is lacking ; otherwise the method previously recom- 

 mended has an advantage, since the degree of extension may be expedi- 

 tiously varied at the will of the operator, which is an important point to 

 be considered, during the actual section of the tendons. 



