OPEEATtoNS UPON FIBROUS TISSUES. 313 



lished characters of a recognized club-foot. In a majority of cases 

 the disease is locaUzed in the tendon of the deep flexor of the 

 phalanges, but it often extends to the superficial tendon as well, 

 or may involve the tarsal or carpal band, or the suspensory ligament. 

 . This deformity of fcnuckhng may exist in three different degrees : 

 either the cannon bone and the phalanges meet in an almost ver- 

 tical line, as in the case of the animal straight or upright on his 

 pasterns, which is the first degree; or the bones meet to form an 

 angle opening backward, the phalanges being somewhat oblique 

 in that direction, instead of f orward,.as in the normal state, and the 

 animal stiU resting on the entire plantar surface of the foot, which 

 is the second degree ; while in the third degree these conditions are 

 still more exaggerated, the animal traveling altogether on his toe and 

 exhibiting a case of the perfect tahpes. This last conformation, 

 which exists principally in the hind legs, is specially due to the 

 retraction of the deep flexor, while in the other degrees it is the 

 superflcial flexor which is diseased. Lesion of the suspensory 

 ligament may coexist in either case. 



The condition of the tendons, from which this deformity arises, 

 is not the only question to take into consideration when the pro- 

 priety of the operation is to be determined. The causes which 

 have produced it must not be overlooked. For example, while in 

 the hind legs the accident has usually a traumatic cause, such as 

 a sprain, violent over-exertion, lacerations, or contusion of tendons; 

 when the fore legs are affected it is most commonly as the accom- 

 paniment of some lesion in other parts of the leg, as of the foot 

 or the digital region proper, such as bad feet, navicular disease, 

 contraction of the heels, corns, quarter and toe-cracks, quittors, 

 deep punctured wounds, and very commonly ringbones, or other 

 exostoses. 



Taking all these various causes into consideration, with their 

 specific natures, and the extent of the lesions which accompany 

 them, we are justified in beheving with Gourdon, that plantar 

 tenotomy is indicated with fair chance of success, when the knuck- 

 hng results from traumatism, and the perforans tendon is alone 

 diseased; and even when both tendons are affected, good results 

 are stiH not improbable; but that it is contrar-indicated whenever 

 complications exist which are Hkely to prevent the leg from re- 

 turning to its natural position, as when the disease is of long 

 standing; when there are alterations of the articular surfaces; 



