PLANTAR NEUROTOMY. 



547 



tlie imdiscovered disease, it will, at least, relieve the lameness, if 

 not in all, yet still in a large majority of the cases. 



In contraction of the heels, or in feet subject to chronic corns, 

 as result of their conformation, and in some cases of chronic 

 laminitis, where there is either no alteration of structure, or very 

 little, as well as in keraphylocele, here also neurotomy is bene- 

 ficial. But it is principally in navicular disease that its advan- 

 tages are best illustrated. And next to these, as best adapted to 

 prove and exemj)hfy its benefits, must be classed ringbones and 

 sidebones, the characteristic exostoses of the digital region. 



Excellent results have followed it when performed for the rehef 

 of the lameness which often supervenes upon severe injuries, or 

 operations about the foot, such as fractures of the phalanges, crush- 

 ing of hoof, or any of the sometimes violent acts of surgical inter- 

 ference necessitated by the diseases of that region. The question 

 has even been discussed of the probability of obtaining beneficial 

 results in tetanus, following traumatic lesions of the foot ; especially 

 in punctured wounds. 



A glance at the counter-indications of neurotomy will furnish 

 a plausible explanation of the objections alleged against it in its 

 earlier history. In the fact that the complications now recognized 

 as thus related to it were then miknown, and consequently un- 

 recognized, and the operation performed notwithstanding, we 

 at once discovered a sufficient reason for the failures and bad 

 results of the treatment, and the consequent' odium into which it 

 naturally fell. It was not yet adequately comprehended — it was 

 misapplied — it was, perhaps, unskilfully performed — it failed. A 

 very logical formula; but it ought not to have been denounced. 



Neurotomy is indicated in navicular disease, and for some in 

 the very iucipiency of the attack, all other modes of treatment 

 being only palliative and temporary, and when it has advanced to 

 its chronic stage an operation will be of Httle advantage, or wholly 

 unsuccessful, if at this period the bone has become extensively 

 diseased, and the tendon reduced to the condition of a mere mem- 

 braneous pellicle. It is also contra-indicated in all forms of acute 

 inflammation of the foot ; in badly formed feet, such as the flat or 

 pumiced of chronic laminitis ; and, again, when the lameness origi- 

 nates ia a very large exostosis or other bony disease likely to be- 

 come a mechanical obstruction to the movements of the articula- 

 tion, or to the play of tendons, or to produce anchylosis. , To 



