CUNEAN TENOTOMY 221 



tibio-astragular articulation. (Fig. 119.) By keeping in the 

 middle of the hock and cutting two inches upward from the 

 head of the large metatarsus, a free, bold, deep incision can 

 be made with impunity. 



Second Step. — Disinfecting and Anaesthetizing the 

 Field. — Having previously applied the twitch and side-line, 

 the whole inner surface of the hock is clipped, shaved and 

 rinsed with mercuric chloride solution, after which a liberal 

 amount of cocaine solution 5% is injected subcutaneously 

 along the line of incision. A few moments may now elapse 

 before proceeding, to allow the cocaine solution to dissem- 

 inate and produce its effects. 



Third Step. — Making the Cutaneous Incision. — The 

 operator stands parallel to the affected leg, facing its ex- 



Fig. 119 — Location of Incision in Cunean Tenotomy. Dotted Lines Show 

 Course of the Tendon. 



ternal surface, leans over the hock and makes an upward 

 incision through the skin at one deliberate stroke, beginning 

 at the head of the large metatarsus and ending two inches 

 higher. The edges of the wound are separated to either 

 side with the dissecting forceps and as the assistant bails 

 out the blood the tarsus fascia is seen in the depths of the 

 wound. Sometimes one or even two cutaneous vessels will 

 bleed quite profusely. These are managed with the artery 

 forceps which are left hanging for a few moments, or even 

 until the operation is completed. If they are allowed to 

 bleed search for the tendon will be more difficult. (Fig. 118.) 

 Fourth Step. — Searching for the Tendon.— When the 

 skin is divided the tendon still remains covered by the tar- 

 sal fascia, a rather thick but somewhat indistinct structure 



