226 VETERINARY SURGICAL OPERATIONS 



ping of the patella over the edges of the trochlea has de- 

 formed it beyond relief. 



EQUIPMENT.— The operation will demand the follow- 

 ing equipment : Scalpel, dissecting forceps, artery forceps, 

 two wound retractors, curved probe pointed bistoury, needles 

 and silk thread for three to five stitches, needle holder, razor, 

 soap and water, mercuric chloride solution 1-500, mercuric 

 chloride 1-2000 in sterilized water, chloroform and anaes- 

 thetic apparatus. 



RESTRAINT.— The operation is performed in the lat- 

 eral recumbent position with the affected leg undermost, and 

 under general anaesthesia. Local anaesthesia is hardly suf- 

 ficient, as a sudden jerk of the leg at the critical moment 

 might plunge the knife into the articulation, and besides the 

 relations of the underlying' structures to the cutaneous inci- 

 sion change with every different position of the leg. The 

 ligament lying parallel to the incision may be found some 

 distance away when the leg takes another position. 



The operating table, or any ordinary casting -harness or 

 ropes will answer. Under profound anaesthesia the leg can be 

 released and brought out to the desired position and effect- 

 ually held by an assistant. The affected leg is slightly flexed 

 at the stifle so as to bring the ligament into a wider field and 

 to make it more conspicuous on palpation. The operation 

 can not very well be performed if the leg is stretched, be- 

 cause in the extended stifle the ligament is hidden among 

 its relations. On the operating table the uppermost leg is 

 hoisted ceilingward, at the same time rolling the patient 

 slightly toward the dorsal posture, and the affected leg is 

 fixed to the table after being drawn slightly backward and 

 well flexed at the stifle. A certain definite position markedly 

 facilitates the operation. It is obtained by bringing the 

 femur as far backward as possible and then folding (flexing) 

 the tibia upon it. This brings the field some distance from 

 the body. If the stifle is left to hug the abdomen the work is 

 hindered. In the casting ropes or harness the uppermost leg 

 is well flexed upon the pelvis and spread outward as if to 

 expose the inguinal region. The patient is rolled toward the 

 dorsal posture and the affected leg is drawn to the proper 

 position with a rope fastened to the lower third of the tibia 

 and pulled backward by an assistant. 



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

 eration.— The ligament is located in the field representing 

 the internal aspect of the flexed stifle. It is easily felt by 

 firm pressure with the finger, extending from the patella, in 



