OPERATIONS ON THE FOOT 97 
internal metacarpal vein, run down the limb in close prox- 
imity with the inner border of the flexor tendons. Also, 
we remember that the external plantar nerve has no atten- 
dant artery, although, like its fellow, it is to be found in 
close touch with the edge of the flexor tendons. 
Bearing these landmarks in mind, we feel for the nerve 
in the hollow just above the fetlock-joint by noting the 
pulsations of the artery, and determining the edge of the 
flexor tendons. This done, a clean incision is made 
with the bistoury or the scalpel in the direction of the 
vessels. The incision should be made firmly and decisively, 
so that the skin may be cleanly penetrated with one clear 
cut. If judiciously made, little else in the shape of dissec- 
tion will be needed. 
It is now that the double tenaculum (Fig. 61) is applied. 
Fic. 61.—Dovusie TENACULUM. 
One clip is fixed to the anterior edge of the wound, and 
the other carried beneath the limb and made to grasp the 
posterior edge. If found desirable to keep the edges of the 
wound apart, and no tenaculum to hand, the same end may 
be accomplished by means of a needle and silk. In like 
manner as is the tenaculum, the silk is attached to one 
edge of the wound, carried under the limb, and firmly 
secured to the other. 
Having made the incision, the wound sbould be wiped 
free from blood by means of a pledget of cotton-wool 
previously soaked in a carbolic acid solution and squeezed 
dry. At the bottom of the wound will now be seen the 
glistening white sheath, containing the vein, artery, and 
nerve. This should be picked up with the forceps, and a 
further incision made with the bistoury. Care should be 
exercised in making this second incision, or the artery may 
7 
