MEDIAN NEURECTOMY 145 



Immediately above the fetlock joint the median metacar- 

 pal or metatarsal nerve divides into an anterior smaller, d, 

 and posterior larger branch, o. This division should be laid 

 bare in order that the operator may not erroneously cut one 

 branch only. Immediately above this point of division the 

 aneurism needle is passed under the nerve, pushed well 

 through and forced up and down, separating the nerye from 

 the adjacent tissues, the scissors or a small probe-pointed 

 bistoury is passed beneath and it is cut through quicjily at 

 the superior angle of the wound. The distal end of the 

 nerve is then dissected free downward and excised at the 

 lower angle of the wound so that a section 3 to 5 cm. long 

 is removed. The cutaneous wound is united by a suture 

 and a temporary bandage applied. If the horse has been 

 secured by casting, the extension splint, if it has been used, 

 is then removed, the foot replaced in the hobble and the 

 horse turned to the other side. The operation on the oppo- 

 site metacarpal nerve is carried out in the same way after 

 which a sterile bandage is applied and allowed to remain 

 eight days. Healing by primary union. , 



42. MEDIAN NETJBECTOMY 

 Fig. S4 



Objects. The relief of lameness due to disease so located 

 in the anterior limb that it cannot be overcome by plantar 

 neurectomy. 



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- 



