322 OPERATIONS ON MUSCLES AND THEIB ANNEXES. 



united. The section must be made above the bifurcation of 

 the tendon, to avoid the artery which passes under it, though 

 it is quite deeply situated, and besides, there is no danger 

 of injuring the synovial sac of the carpal arch. The obhque 

 flexor is situated back and inside of this, and has its tendon single, 

 terminated on the trapezium, with the posterior tendon of the 

 external flexor. The section must be made before the union of 

 the two tendons, in order to avoid injury to the carpal arch. 



The animal is throvm, and the knee extended with two ropes, 

 one above and one below the knee, and drawn in opposite direc- 

 tions. The same instruments are used for carpal as for plantar 

 tenotomy. 



The incision of the skin is made about two inches above the knee 

 with the straight tenotome, immediately in front of the tendon, 

 which is easily felt under the skin, and is raised with the fingers ; 

 the curved tenotome is inserted between the skin and the tendon, 

 from before backward, and the section made as in the plantar 

 operation. Gourdon suggests the introduction of the knives 

 under the tendon instead of between that and the skin. By this 

 mode the division is made from within outward, while in the 

 other way it is made from without inward. 



The external flexor being thus divided, the section of the 

 middle flexor is made a Httle below ; the puncture of the straight 

 tenotome is made between the two tendons, and the curved 

 tenotome inserted as before, between the skin and the tendon 

 from before backward, or preferably, from vsithout inward, and 

 when its blunt end is felt on the posterior border of the muscle, 

 the section is made from without inward, with the usual motion of 

 the knife. Only a simple dressing is required, but the animal 

 must be kept at rest for at least a month. 



The modus operandi to which we give the preference over that 

 which we have just narrated, and which we have described ia our 

 work on lameness, is very simple. The animal being thrown, on 

 the side opposite to that of the operation, and the knee extended 

 as usual, the operator, who is in front of the knee, feels for the 

 space between the two muscles, where they are about to unite, 

 and this being found, a straight tenotome is introduced through 

 the skin from before backward, about two inches above the super- 

 ior border of the trapezium, and under the thickness of the 

 middle flexor, and when the point of the instrument is felt on the 



