PERONEAL TENOTOMY 



215 



far as possible. If only a cutaneous incision is made the 

 probe-pointed bistoury will be blocked by the underlying 

 connective tissue, in its downward passage. The bistoury 

 is passed flatwise beneath the tendon and then turned against 

 it. The division is then effected by pressing the tendon 

 against the sharp edge with the thumb. 



To resect a part of the tendon a cutaneous incision is 

 made, one-half inch long, along the course of the tendon 

 at its most conspicuous part. ( The tendon is then brought 

 out with a nerve elevator or tenaculum, stretched as tight 



Fig. 116 — Side-Line Restraint and Position of Operator in Peroneal 



Neurotomy. 



as possible and then divided, first superiorly and then in- 

 feriorly. An inch is easily resected in this manner. 



A third method, somewhat more complicated than the 

 preceding, consists of first elevating the tendon through 

 a half-inch incision made as low as possible and then dividing 

 it subcutaneously an inch higher, so that a long piece of 

 the .tendon can be pulled out of the incision. After the 

 tendon has been elevated through the lower incision, the 

 bistoury is passed under it an inch or so higher up and as 

 its blade is turned against it, traction is applied to the 

 elevator to facilitate its division by increasing the tension. 

 When the division is effected a firm pull will bring the 



