178 SUBCUTANEOUS AMPUTATION OF ANTERIOR LI MBS 



Technic. Attach a cord to the inferior maxilla of the 

 fetus and have one or more assistants draw the head out as 

 far as possible. 



Some obstetrists have found difficulty in applying traction 

 to the inferior maxilla by means of a cord. First make a 

 perforating wound with the knife between the rami of the 

 lower jaw, then carry the looped cord over the jaw and push 

 it beyond the perforating incision with the loop resting 

 within the mouth, and finally pass the free end of the cord 

 through the perforation from the buccal cavity outward, 

 and drawing upon this the inferior maxilla is so engaged 

 that it will pprmit the application of powerful traction. 



Make a circular incision at a convenient point through 

 the integument encircling the head and separate the skin 

 backward toward the occiput by forcing the hand between 

 it and the bones or by using the chisel as a spatula or 

 dissecting it away with the Colin's scalpel, continuing the 

 separation over the occiput to the atloid region. Make a 

 transverse incision below across the trachea and esophagus 

 and surrounding muscles and above through the ligamentum 

 nuchse. Grasp the head firmly with both hands and twist 

 it forcibly on its long axis rupturing the articular ligaments 

 and the remaining muscles and other .soft tissues, detaching 

 the head at the occipito-atloid articulation. The removal 

 of the head greatly diminishes the bulk of the fetus and it 

 may now be repelled, or deviated parts brought into the 

 desired position and other operations performed. 



53. STJBCTJTANEOTJS AMPUTATION OF ANTERIOR 



LIMBS 



Objects. Amputation of the anterior limbs is very fre- 

 quently called for in equine obstetric practice, chiefly in 

 cases of transverse presentation with all four feet presenting 

 and the head retained where it may be impossible to safely 

 correct the deviation, in cases of wry neck in the foal in the 

 anterior presentation, when it is impossible to correct the 

 deviation of the head, or in any case in the mare or cow 



