PATELLAR DESMOTOMY 223 



cleansed, matted with idoform and then recoated with col- 

 lodion or a clay dressing. If the wound becomes infected 

 soon after the operation, a circumstance that should not be 

 permitted to occur, the drainage orifice is widened by the 

 application of a pledget of wadding, and the wound fre- 

 quently irrigated with hydrogen peroxide. The stitches are 

 not disturbed -unless the infection is virulent and threatening, 

 in which case the whole wound is laid bare and treated as an 

 open one. 



At least six weeks of rest should be allowed after cunean 

 tenotomy, if any benefit is to be derived. An immediate re- 

 turn to work after the cutaneous incision has healed will 

 deprive the operation of whatever benefit might have been 

 otherwise derived. 



- ACCIDENTS AND SEQUELiE.— The only accidents 

 liable to occur during the operation are wounding of the vena 

 saphena by making the incision too far forward, or wound- 

 ing the capsular ligament if made too high. These, however; 

 could result only from gross carelessness. 



The most serious sequel is infective inflammation of the 

 surroundings or abscess, manifested by the appearance of 

 swelling and acute lameness before the wound has healed. 

 Ordinarily this complication is not dangerous, but may cause 

 considerable anxiety for one or two weeks by threatening 

 to implicate the articulation. 



A second sequel is the enlargement of the exostosis. 

 Cunean tenotomy enlarges the spavin but never decreases 

 its size. It transforms the circumscribed exostosis into a 

 wider one. The exostosis seems to grow upward into the 

 . space previously occupied by the excised tendon. For a 

 long time after the operation, two, three or four months, 

 the whole internal face of the hock is tumefied, seemingly 

 with permanent new tissue, but this finally reduces until 

 only the exostosis remains. 



Patellar Desmotomy- 



SYNONYMS. — Patellar syndesmotony ; radical oper- 

 ation for the cure of habitual luxation of the patella. 



DEFINITION. — Patellar desmotomy is the surgical di- 

 vision of the internal straight ligament for the purpose of cur- 

 ing the congenital abnormality of colts, usually described 

 under the name of "habital luxation of the patella." 



HISTORY. — The operation is the artifice of Bassi, and is 

 one that has only recently been introduced into this coun- 



