Flexion of Anterior Limbs at Carpus 761 



position, its correction is usually easier than when the fetus pre- 

 sents dorso-sacrally, and is to be brought about in a corresponding 

 manner. If the fetus is presenting in a dorso-pubic position, it 

 will be necessary to press the carpus downward in the front of 

 the pubis and bring the toe of the foot along beneath the sacrum 

 in order to extend it. In the dorso-ilial position, the retained 

 carpus is pushed outwards in front of the shaft of one of the ilia, 

 while the toe is carried over the ilium of the other side and ex- 

 tended in the birth canal. After. the limbs have been properly 

 extended in the birth canal, the fetus is to be rotated upon its 

 long axis, page 632, and brought into the dorso-sacral position. 



2. Forced Extraction. Under certain conditions forced ex- 

 traction may be advisable. Some obstetrists highly recommend 

 it, especially in the case of a living foal. Naturally, it is only 

 practicable in those cases where the bent carpus is already ad- 

 vanced in the pelvic canal, or is in a position where it may be 

 readily secured and brought into the pelvic canal in its state of 

 flexion. In these cases, especially when a foal is living and 

 prompt delivery is essential to the preservation of its life, the 

 flexed carpus may be grasped by the hand, or a cord may be ap- 

 plied to it. By exerting firm traction, the shoulder, arm and 

 forearm are normally extended, the flexed carpus advanced, the 

 entire body then advanced by the application of force, and the 

 fetus delivered. 



3. Embryotomy is rarely demanded except to the extent of 

 the preliminary decapitation, which is desirable in order to facili- 

 tate repulsion. It is rarely, if ever, essential or advisable to 

 amputate the anterior limbs at the carpus. 



3. Complete Retentiot^ of the Anterior Limbs. 



Instead of the limb being flexd at the carpus, as in the pre- 

 ceding instance, we meet with cases in which one or both anterior 

 limbs are completely retained, and assume the position shown in 

 Fig. 132. Under these conditions one or both carpal articula- 

 tions project down deeply into the uterine cavity in front of the 

 pubis of the mother, with the radius fully extended upon the 

 humerus, so that those two bones constitute one elongated, rigid 

 column. In this position of the fetus there can be no yielding 

 in a posterior direction from the scalpulo-humeral articulation to 

 the carpus. As a consequence of this deviation, the shoulders of 



