TENOTOMY. 
581 
undesirable to follow Fogliata, who first divides the perforatus tendon, 
and when this is not sufficient, cuts through the perforans. If the 
horse, when quietly standing, places sufficient weight on the leg, it may 
be placed in a stall, better still in a box: otherwise, on the second day 
after operation, it should be slowly walked for a quarter to half an hour, 
when possible on soft ground. This is almost indispensable to prevent 
cicatricial contraction and ensure restoration of the normal fetlock 
position. The frequent relapses noted are 
due to neglect of this precaution. For a 
similar reason, operation must be delayed 
until pain has almost disappeared, other¬ 
wise the requisite weight cannot be put on 
the limb. Experiment shows that mechani¬ 
cal extension of the cicatricial tissue is 
necessary to produce the characteristic 
spindle - formed cellular elements, i.e ., to 
give newly-formed tissue the character of 
tendon substance. 
It almost goes without saying, that, either 
before or soon after operation, the foot must 
be restored to its proper form by judicious 
paring. Animals can sometimes be returned 
to work in ten weeks ; sometimes, however, 
pain continues, preventing them being put 
to rapid work for a longer interval. When 
it persists, the lameness may generally be 
removed (in animals which cannot be kept 
idle) by dividing the median nerve. Mdller 
repeatedly performed neurectomy and teno¬ 
tomy simultaneously in horses belonging to 
a large horse-owner, who loaded his horses 
heavily, and worked them hard; and where 
lameness was still marked, has treated both 
contracted tendons and shot-over fetlocks, 
due to contraction of the suspensory liga¬ 
ment, at the same time, and rendered horses workable again even in 
four to five weeks. 1 Median neurectomy is first performed, then teno¬ 
tomy. For a description of median neurectomy, see the section on 
“Ringbone ” hereafter. As the neurectomy wound rarely heals by first 
intention, it must, during the first few days, be frequently cleansed to 
prevent discharges running down and infecting the lower point of 
operation. The excessive dorsal flexion (fig. 216) following simultaneous 
Fig. 216.—Excessive dorsal flexion 
after section of the perforans and 
perforatus tendons—the ‘•'knuck¬ 
ling over” at the fetlock is due to 
contraction of the suspensory liga¬ 
ment, and has not been affected 
by the operation (from a photo¬ 
graph). 
1 Mdller’s own statement : “ Wurde . . . die Pferde oft schon nach 4—5 Wochen arbeitsfahig.” 
