RESECTION OF FLEXOR PEDIS PERFORANS TENDON. 
781 
a tampon, moistened with the same fluid, is thrust into the wound, and 
a dressing applied. 
Disease of the flexor pedis perforans tendon can in general only be 
cured by resection. The procedure is as follows:—On the day pre¬ 
ceding operation, the sole, frog, and especially the bars, are very 
thoroughly thinned, the foot is cleansed, the hair clipped carefully away 
as high as the fetlock or knee, and the limb immersed for half an hour 
in a bucket of strong disinfecting solution. Whilst immersed it is 
subjected to a thorough scrubbing with a clean stiff brush. Imme¬ 
diately after removal the foot and hoof must be completely enveloped 
in clean cloths saturated with a disinfecting solution. 
Next day the horse is cast. The affected foot is released, the sole, 
frog, and bars still further thinned, and the sensitive frog is exposed so as 
to allow any necrotic portions either of the frog or tendon to be removed. 
An Esmarch’s bandage is then applied to the limb, commencing at the 
coronet and extending to above the knee, at which point a stout rubber 
cord under tension is passed several times round the limb and the ends 
tied together. This secures the operator against troublesome bleeding. 
The foot to be operated on may then be fastened to the other limb of 
the same side by means of webbing. The horse is now chloroformed. 
Two methods of procedure are at the operator’s disposal, in the first of 
which only a portion of the point of the frog is removed, in the second 
the whole. The first method is often sufficient to disclose the diseased 
tissues, and it has the advantage of producing a much smaller, and there¬ 
fore more rapidly-healing, wound than the second. The sole, frog, and 
bars having been pared until they yield everywhere to a slight pressure 
with the finger, a grooved director is passed into the sinus, which is 
freely laid open to its extremity. Using the curved knives shown on 
p. 798, the edges of the wound and the plantar cushion are then removed 
so as to produce an elliptical opening, at the base of which lies the 
perforans tendon. If the superficial fibres of the tendon are necrotic the 
operator may confine himself to removing such diseased tissue. But 
much more frequently he finds it necessary to remove the entire 
thickness of the tendon beneath the diseased spot and to extend his 
incision laterally so as to operate in sound tissue. The portion of the 
navicular so exposed may be curetted, if it show signs of disease. 
The wound is then washed out with a disinfectant, dusted freely 
with iodoform, and filled with masses of disinfected tow, oakum, or 
wood-wool. 
When carefully performed this partial operation is sometimes rapidly 
successful, but on the whole it is apt to prove uncertain, and to be 
followed by troublesome complications. The tendon sheath becomes 
the seat of suppurating synovitis ; the navicular bone shows superficial 
