METACARPAL TENOTOMV 205 



fore, be followed by treatment that will tend to benefit the 

 original disease to which it was due. Firing, blistering, ap- 

 propriate shoeing, and long rest or easy work are often help- 

 ful in bringing about a satisfactory termination of the opera- 

 tive treatment. 



In the ox and dog similar deformities are rare; the de- 

 formity is seen chiefly in solipeds, because these animals 

 alone are constantly submitted to th& arduous work, and are 

 exposed to the kind of injuries that are capable of causing the 

 particular lesions from which contracted tendons emanate. 

 However, in the absence of any evidence to ■ the contrary, 

 it is reasonable to theorize that nail pricks, thecal abscesses, 

 fractures, etc., may sometimes cause the deformity in these 

 domestic species. 



EQUIPMENT.— The division of the tendons is effected 

 with the same special bistoury described under the head of 

 carpal tenotomy (Fig. 5). A common tenetome, pricking 

 knife, sharp-pointed curved bistoury may, however, be sub- 

 stituted in the absence of this special bistoury. The other 

 requirements are: Scalpel, clippers, razor, hoof-knife, hoof- 

 nippers, hoof-chisel, bandages in abundance, antiseptic solu- 

 tions. 



RESTRAINT. — The operation is performed in the re- 

 cumbent position with the affected leg undermost and 

 stretched out at a right angle from the body. General anaes- 

 thesia is helpful, and is especially demanded, when there are 

 firm adhesions to break down after the .tendons are divided. 

 The division of the tendons alone is not very, painful, but the 

 breaking-down process inflicts a torturing pain that de- 

 serves consideration. Local anaesthesia is of no service 

 whatever. 



The leg itself is secured with two ropes, one passing from 

 the knee backward to some fixed point, and a second one 

 looped around the pastern and brought forward around the 

 heel of the foot. The first is a stay rope to prevent the leg 

 from' pulling forward, while traction is applied to the other 

 one to break down the deformity. 



The operating table and casting harness are both suit- 

 able apparatuses to restrain the subject, but the former is 

 somewhat more convenient. 



TECHNIQUE.— First Step.— Locating the Seat of Op- 

 eration.— The division of the tendons is effected exactly at 

 the middle of the metacarpus, a point devoid of synovials. 

 At the lower third is the superior cul-de-sac of the sesamoi- 

 dean synovial, while at the upper third is the inferior exten- 



