THE SUSPENSORY LIGAMENT— DESMOTOMY 137 



bending of the foot towards the side of the shorter division of the 

 ligament, and we have what is known as congenital malformation of 

 the fetlock, due primarily to the condition of the ligament. 



The treatment is obviously desmotomy of the shorter of the two 

 branches, after which the limb may be forcibly straightened. This 

 operation is sometimes performed where the branch is crossing the 

 suffraginis. In this position the operation is extremely simple, as it only 

 necessitates a small incision being made transversely across the liga- 

 mentous band, when the subcutaneous ligament may be severed either 

 with or without exposing it through the cutaneous incision. If it is 

 desired to bring the ligament through the cutaneous opening before 

 section, this will be facilitated by making the incision along the line 

 of direction of the ligament. But the o])eration in this situation 

 is not always attended with successful results, on account of the 

 attachment of the ligament to the sesamoid bone. It is therefore 

 frequently advisable to adopt a seat above this attachment, e.g., 

 immediately below the point where the ligament divides, when 

 the incision is made at a level which is from two to three inches 

 lower down the limb than that selected for performing desmotomy of 

 the whole ligament. In this case careful dissection is necessary to 

 expose the ligament, which is here somewhat cord-hke in appearance. 

 A curved tenaculum similar to one used in neurectomy may then be 

 passed beneath the ligament, and the latter exposed through the 

 cutaneous opening and divided with a knife or a pair of scissors, as in 

 neurectomy. 



