RESECTION OF THE FLEXOR PEDIS TENDON 167 



48. RESECTION OF THE FLEXOR PEDIS TENDON 



Fig. 64 



Object. The removal of necrotic tissues and disinfection 

 of the parts in cases of infected wounds, chiefly of nail 

 wounds of the navicular bursa. 



Instruments. Elastic ligature, drawing knife, sage knives, 

 scissors, tenaculum forceps, curette, scalpels, tenacul^, 

 bandage material. 



Technic. Thin the horn of the sole, frog and bars until 

 every part of the horny covering of the sole is thin, soft, 

 and yielding. If opportunity offers, apply an antiseptic 

 bandage for 24 hours. Secure the patient on the operating 

 table or by casting in lateral recumbency with the affected 

 foot extended. Anaesthetize. Cleanse and disinfect the 

 entire foot with soap, brush, creolin or sublimate solution 

 and 50% alcohol and apply the elastic tourniquet in the 

 metacarpal or metatarsal region. Apply towels saturated 

 with antiseptics as in preceding operation. Make a trans- 

 verse incision through the base of the frog, 2 to 3 cm. from 

 the balls, through the horny and sensitive portions and the 

 fatty cushion down to the flexor pedis tendon. Follow this 

 by two converging incisions extending forward and inward 

 in an oblique direction corresponding to the semi-lunar crest 

 of the OS pedis, the lines of incision being in the bars about 

 y^. cm. outward from the lateral groove of the frog and 

 uniting at its apex. The triangular piece of frog which 

 has been isolated by the incision is now grasped with the 

 tenaculum and dissected away. The remnants of the fatty 

 frog should be removed with the sage knife or scalpel by 

 means of a horizontal incision. There is then revealed the 

 flexor pedis tendon which may be greenish or yellowish 

 colored and necrotic, or may be covered with reddish- 

 colored granulations. 



Should there be present also suppurative pododermatitis, 

 the bars on the affected side must be excised along with 

 the other portions. 



