. Minor and operative surgery, including bandaging . Blunt-pointed tenotomes. The Tendo-Achillis.—In dividing this tendon, a sharp-pointed tenotome should be entered at the inner borderof the tendon about an inch above its attachment to thecalcaneum (Fig. 479); the heel should be depressed as Fig. Tenotomy of tendo-Achillis. much as possible, so as to make the tendon prominent, anda sharp-pointed tenotome passed through the skin andbehind the tendon ; it is next withdrawn and a blunt-pointed tenotome introduced and the tendon divided. Theposterior tibial artery, nerve, and vein lie to th
. Minor and operative surgery, including bandaging . Blunt-pointed tenotomes. The Tendo-Achillis.—In dividing this tendon, a sharp-pointed tenotome should be entered at the inner borderof the tendon about an inch above its attachment to thecalcaneum (Fig. 479); the heel should be depressed as Fig. Tenotomy of tendo-Achillis. much as possible, so as to make the tendon prominent, anda sharp-pointed tenotome passed through the skin andbehind the tendon ; it is next withdrawn and a blunt-pointed tenotome introduced and the tendon divided. Theposterior tibial artery, nerve, and vein lie to the inner side,and are not likely to be injured if the tendon is dividedat this point. The Posterior Tibial Tendon.—This tendon may bedivided above the inner malleolus. The muscle is madetense by everting the foot, and the tenotome is entered atthe inner side of the tendon and passed behind it. Theposterior tibial tendon may also be divided upon the sideof the foot; for this operation the foot is everted, and thetenotome is passed from above downward and under the OPERATIONS UPON TENDONS. 569 upper border of the tendon at a point half an inch belowand in front of the tip of the internal malleolus. To avoidinjury of the posterior tibial artery and nerve the openoperation is generally practised up
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