578 
INFLAMMATION OF THE FLEXOR TENDONS. 
Tenotomy is the only method of treating severe “knuckling over” 
due to contraction of the tendons, but is only useful if no joint be 
involved, and if the contracted tendon be not adherent to its sheath 
at some point below the seat of operation, because, in order to allow 
the fetlock to resume its normal position, the lower end of the divided 
tendon must retract. Where the knee is simultaneously bent, the 
upper portion of the tendon must also be able to retract to allow the 
knee to straighten, but the operation is then seldom of use, because 
the bent position is due to shortening in the flexor muscles of the knee 
and metacarpus. Before operating, lameness must be allowed to 
subside, one of the conditions of success being that the limb shall 
afterwards carry some weight, without which the tendon further 
contracts. 
Fig. 212. —Section through the centre of the metacarpus. 
a, Large metacarpal artery ; b, metacarpal vein ; c, inner plantar nerve ; def, corre¬ 
sponding external structures ; g g g, interosseous arteries ; Jc, oblique branch 
from internal to external plantar nerve ; l, tendon of flexor perforans ; m, its 
reinforcing band; n, tendon of flexor perforatus. 
Tenotomy aims at lengthening the contracted tendon. It may be 
performed in various ways, though the subcutaneous is the only really 
successful method. Some operate from the outer side, and direct the 
incision either towards the suspensory ligament or towards the skin. 
The inside is preferable, because of the absolute guarantee this gives 
against injury of the metacarpal artery. The operation is, however, 
only valuable in young and high-priced horses, because recovery and 
restoration to work require six to eight weeks or even longer. 
At the inner side of the leg, about the middle of the metacarpus, 
the hair is shaved, and the entire metacarpus washed with soap and 
water and rinsed with sublimate solution. A ring of sublimate wood¬ 
wool is then laid round the point of operation, fixed by a bandage, and 
moistened three times a day with sublimate solution. In this way in 
twelve to twenty-four hours the metacarpus is rendered completely 
aseptic, so that aseptic healing may be reckoned on with certainty 
