174 NEUROTOMY OF THE MEDIAN NERVE. 



38. NEUROTOMY OF THE MEDIAN NERVE. 

 PlatB XXVIII. 



Objects. The relief of lameness due to disease so located 

 in the anterior limb that it cannot be so well overcome by 

 plantar neurotomy. 



Instruments. Razor, scissors, convex scalpel, artery 

 and compression forceps, tenacula, aneurism needles, suture 

 material. 



Technic. The operation is performed on the median 

 surface of the anterior limb immediately below the humero- 

 radial articulation on the recumbent horse after the affected 

 foot has been fully extended on the operating table or in de- 

 fault of this removed from the hobbles and bound upon the 

 extension splint as shown in Plate XXIII. Anaesthetize. 



The foot is drawn out firmly from the shoulder, incHned 

 somewhat forward. The operator places himself between 

 the neck and the forearm of the patient and, after the median 

 region of the elbow joint has been washed with soap and 

 water, searches for the median nerve where it glides over 

 the posterior part of the joint to disappear behind the radius. 

 Shave the skin at and below this point, disinfect it with 

 sublimate or creolin solution and 50% alcohol. The nerve, 

 n, lies as a rule somewhat in front of the middle of the 

 median side of the forearm against the postero-internal 

 margin of the radius and can be felt, about 5 to 6 mm. in 

 diameter, lying somewhat deeply. The position of the 

 nerve varies with the different attitudes of the forearm. In 

 fat and fleshy horses the identification of the nerve is more 

 difficult. It may be felt upon the standing animal. 



With the nerve lying between the thumb and index finger 

 of the left hand, at the point where it begins to disappear 

 behind the radius after having passed over the humero-radial 

 articulation, stretch the superposed skin and immediately 

 upon and parallel to it make an incision 5 cm. long, first 

 through the skin, then through the aponeurotic expansion 



