ENLARGEMENTS ON THE OUTER SURFACE OF THE HOCK. ](J13 



tissue to be divided down to the underlying fascia. After again 

 ascertaining by palpation the exact position of the nerve the fascia 

 is divided in the same direction and to the same extent as the skin 

 wound. A fragment of fascia about \ inch wide may then be 

 removed with scissors, whereupon the nerve, recognisable by its 

 white colour and fibrous consistence, usually projects through the 

 opening. A thread is passed under it with a blunt-pointed needle ; 

 and a piece an inch in length is then dissected free, and divided as 

 high up as possible and again at the lower limit of the wound with 

 knife or scissors. 



As healing by first intention is rather difficult to attain, sutures 

 are only necessary where rather severe bleeding occurs. 



The formation of a neuroma on the central end of the divided nerve 

 is uncommon, and when occurring is usually due to the fact that the 

 end of the nerve has been left too long, so that it projects into the 

 operation wound. Should it occur, however, it may necessitate a 

 second operation for its removal, and in this event it is usually best 

 to operate at a higher point, as the formation of fibrous tissue usually 

 renders it difficult to find the divided end. 



Double neurectomy of the anterior and posterior tibial nerves 

 is not without danger, trophic changes in the foot, local sloughing, 

 and loss of the hoof often occurring. The operation has nevertheless 

 proved successful when all other methods have failed. Bosi, who 

 introduced it, has had a number of very favourable results, as have 

 Frohner and Schimmel. Necessarily it does not modify the changes 

 in the joint, though it may remove the lameness. 



The shoeing is of some importance. Klemm recommends raising 

 the heels, and giving long quarters and a short toe, a suggestion 

 supported by experience. Koster also recommended shortening 

 the toe of the foot before treatment, and using long, wide shoes, with 

 heels and toe-pieces. 



VI.— ENLARGEMENTS ON THE OUTER SURFACE OF 

 THE HOCK. 



The above title includes all circumscribed thickenings on the 

 outside of the hock-joint. They may be situated in the ligamentous 

 apparatus, particularly in the outer lateral ligament, or may arise 

 from the cuboid, outer small metatarsal or other bone of the hock, 

 but seldom from a joint. Careful examination shows the nature of 

 the condition, which usually results from kicks or other injuries of 

 the outer surface of the hock. Sometimes it accompanies spavin, 



