IV. OPERATIONS ON THE EXTREMITIES 

 37. TENOTOMY OF THE FLEXORS OF THE PHALANGES 



Fig. 49 



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. 



Quiet horses may be operated upon in the standing posi- 

 tion with local anaesthesia. Otherwise secure upon the 

 operating table with the affected member undermost and 

 the foot fully extended, or in default of a table, confine in 

 lateral recumbency and apply an extension splint to the foot 

 as shown in Fig. 49. 



On the median side at the middle of the metacarpus or 

 metatarsus, the skin is shaved and disinfected over the ten- 

 don 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 reunion. 



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 per- 

 pendicularly in the right hand is introduced with the cut- 

 ting edge toward the body through the skin, subcutem and 

 fascia down to the flexor pedis tendon. Immediately on 

 the anterior border of the tendon, insert the tenotome so far 



