156 ANTERIOR TIBIAL NEURECTOMY 



long, parallel to the teudo-Achilles. The white, rigidly- 

 stretched crural fascia is now divided in the same direction, 

 after which the precise location of the nerve should be de- 

 termined by palpation. Excise with the scissors an elliptic 

 or oval piece of the fascia directly over the nerve, or hold 

 it apart along with the lips of the cutaneous wound by 

 means of the tenacula. In poor horses the contour of the 

 nerve, covered only by loose connective tissue, stands out 

 prominently ; in fat horses it is surrounded by a large amount 

 of adipose tissue. Cut through this fat and connective tissue 

 and expose the tibial nerve, «, Fig. 57, and NS, Fig. 58, 

 to view; immediately before it, lies the plantar vein and 

 on the lateral side is situated the recurrent tibial artery, 

 SA, Fig. 58. The cross section in Fig. 58 is located some- 

 what below the point for operation and the vein has crossed 

 obliquely over the nerve so that it appears behind instead of 

 in fro7it of it, as is the case generally at the point where the 

 operation is performed. Separate the vessels completely 

 from the nerve with the handle of the scalpel, pass an 

 aneurism needle from before backward beneath it through 

 to the handle and grasping both ends, force the instrument 

 upward and downward in order to separate the nerve trunk 

 from the adjacent tissues. Cut the nerve off at the upper 

 and lower angles of the wound, removing a section at least 

 5 cm. long. Suture the cutaneous wound and apply a 

 bandage allowing it to remain eight days. Healing should 

 occur by first intention. 



45. ANTERIOR TIBIAL NEURECTOMY 



Nenrectomy of the Deep Branch of the Peroneal Nerve 



Figs. 58, 59 



Object. An adjunct operation to the preceding, since this 

 nerve supplies sensation to the tarsus in common with the 

 sciatic. The two constitute what is known as Bossi's double 

 neurectomy for spavin. 



Instruments. Same as in the preceding. 



