PLANTAR NEURECTOMY. 887 



case. By observing antisepsis primary union can be obtained. After 

 ascertaining the position of the nerve by palpation an incision about 

 an inch long is made directly over it. The nerve is readily recognised 

 by its fibrous appearance and lighter colour. Any trifling bleeding 

 is checked with tampons of cotton-wool and the nerve freed from 

 surrounding tissues with a few touches of the knife. A thread is 

 then drawn under the nerve with the tenaculum, and a portion of the 

 nerve about an inch long is freed and then divided at the upper angle 

 of the wound, with knife or scissors. The animal, if not anaesthetised, 

 usually struggles at this stage. Division of the lower part of the 

 nerve is unattended with pain. Blood is removed with tampons 

 of cotton-wool and the parts cleansed, if necessary, with sublimate 

 or carbolic solution. The skin is brought together with one or two 

 interrupted silk sutures and the parts covered with iodoform collodion, 

 wound gelatine, or a small cotton-wool dressing. 



The operation on the outside of the limb is performed in a precisely 

 similar manner, the point of incision only differing. The nerve can 

 readily be discovered at the point where it passes with the digital 

 artery over the fetlock-joint as a small hard cord which rolls under 

 the finger. Figures 499 to 503 clearly show the position. 



The wound usually heals in five to eight days, provided antisepsis 

 has been observed and the incisions skilfully made. It is best, if 

 possible, to avoid washing out the wound with disinfectants, as the 

 tissues are thereby irritated and healing is retarded. In a word, 

 asepsis is preferable to antisepsis. 



Neurectomy can be performed without casting by injecting 

 20 to 40 minims of a 10 per cent, solution of cocaine into the subcutis 

 immediately within the area of operation. By applying an Esmarch 

 bandage and rubber cord the operation can be performed without 

 bleeding. The horse's foot can be placed on a farrier's shoeing block 

 so as to bring it to a convenient height for operation. 



Sometimes the horse becomes sound immediately after operation, 

 sometimes lameness only disappears by degrees. In other cases 

 improvement is effected, but the animal does not become sound. 

 Such cases are usually due to recurrent sensibility, or to mechanical 

 interference by bony growths with the play of the joints. The horse 

 should be rested for several weeks or closely watched, in order to 

 note any possible signs of degeneration in the tendons or inflammatory 

 changes in the foot. 



Nocard has shown that the uprightness of the foot often diminishes 

 and the size of the bony growths becomes less after plantar 

 neurectomy. 



