hughes' operation for bog-spavin 437 



Hughes' Operation for Bog-Spavin. 



DEFINITION.— Ligation of the vena saphena above 

 and below a bog-spavin, for the purpose of diminishing the 

 size of the fluctuant tumefaction. 



INDICATION.— Bog-spavin belongs to that class of 

 synovial distentions that are predisposed by lack of support 

 of the capsule. The stimulation of synovial secretion in- 

 cident to severe exertion, rheumatic diatheses or aberrations^ 

 of growth and development, cause the capsular ligament of 

 the tarsus to bulge between the tendon of the flexor 

 metatarsi and the internal straight ligament, a triangular 

 space unsupported by any structure except the elastic com- 

 mon integument. This space is traversed diagonally by the 

 large vena saphena, which, if slightly varicosed, adds to the 

 size of the enlargement. 



By ligating this large vein a clot forms within its walls, 

 which, after undergoing the usual transformation into a firm 

 connective tissue thrombus, produces a substantial support 

 to the distended capsule, and generally a marked diminution 

 in its size. 



The exact value of this operation has not been determined 

 by sufficient experience to warrant its absolute adoption in 

 the treatment of bog-spavin. Hughes, however, recom- 

 mends it highly and even claims that it cures the lameness 

 that sometimes accompanies old bogs by incarcerating with- 

 in the ligature the one or sometimes two internal saphenic 

 nerves that follow the course of the vein. The fact, how- 

 ever, that this nerve is little concerned in supplying sensa- 

 tion to the tarsal structures leaves the theory somewhat un- 

 supported. 



RESTRAINT. — The operation can be performed in the 

 standing position by the aid of the single side-line to raise 

 the opposite leg, and local cocainization of the two small 

 fields of operation. The recumbent position on the oper- 

 ating table with the addition of cocaine anesthesia is 

 preferable. 



INSTRUMENTS, ETC.— 



1. Razor and clipper. 



2. Scalpel and dissecting forceps. 



3. Aneurism needle, or common full curved needle. 



4. Sterilized catgut. 



5. Antiseptics. 



TECHNIQUE.— Two spots, one on the course of the 



