244 VETERINARY STATE BOARD 



Symptoms: Chronic enlargement around the coronet joint. 

 Lameness in which the latter phase of the stride is shortened. 

 In the articular form, lameness is seen when the patient is turned 

 in short circles toward the diseased side. Tenderness of the swell- 

 ing is usually present. The phalanges show volar flexion, that is, the 

 fetlock is upright. 



Treatment: Shoe with raised heels and shorten the toe, that 

 is, prepare and shoe the foot so that the pastern lies parallel with 

 the walls of the hoof. Point firing and blisters are beneficial if the 

 animal is rested four to six weeks. This failing to remove the lame- 

 ness, neurectomy is the last resort, but is of value only when 

 anchylosis has not occurred. In the latter condition, the lameness 

 is mechanical and may be relieved by the use of a rolling-motion 

 shoe. 



Describe neurectomy of the median nerve. 



This operation may be performed under local or general anaes- 

 thesia. The point of operation is opposite the lower portion of 

 the elbow-joint, immediately behind the upper extremity of the 

 radius, toward the upper point in the depression between the radius 

 and the internal flexor muscle of the metacarpus. The nerve can 

 be exactly located by palpation. Shave and disinfect the skin and 

 make an incision 5 cm. long, parallel to and directly over the nerve, 

 through the sHn and sterno-aponeuroticus muscle, exposing the anti- 

 brachial fascia. Divide the fascia and, if necessary, remove a small 

 elliptical piece of the same. Pass an aneurism needle under the 

 nerve and separate it from the neighboring tissues. Excise a sec- 

 tion of the nerve 3 cm. long. Disinfect the wound and suture. 

 (Care should be taken to avoid injuring the brachial vein, as hemor- 

 rhage from same would be very annoying.) 



Mention the diseases in v^hich median neurectomy V70uld be indicated. 



Navicular disease, ring-bone, side-bones, chronic sesamoiditis, 

 splints, chronic carpitis. In the latter three, ulnar neurectomy 

 ought also to be performed. In chronic synovitis (articular and ten- 

 dinous) with permanent lameness, median neurectomy may be 

 performed. 



Describe the operation of high plantar neurectomy. 



Operate on the standing animal, using local anaesthesia. The 

 point of operation is just above the fetlock in the lower third of the 

 metacarpus, and just in front of the flexor pedis tendon. The exact 

 point is determined by feeling the nerve glide beneath the fingers. 

 Shave and disinfect a small area. Make an incision 3 to 5 cm. long. 



