134 •VETERINARY SURGICAL OPERATIONS 



trivial except when one of the collateral vessels is accident- 

 ally divided or incised in the course of the operation. The 

 plantar or digital vessels are sometime wounded in the course 

 of the dissection or else divided transversly after being mis- 

 taken for the nerve. The posterior radial vein and artery are 

 so closely related to the median nerve at the seat of opera- 

 tion as to expose them to the same danger. Serious haemor- 

 rhage results from cutting these vessels should be controlled 

 by proper ligation. 



GENERAL TECHNIQUE.— Only the principles will be 

 considered under this head as the details will be given in the 

 description of each special neurotomy. 



Restraint. — Neurotomy is a very painful operation, ne- 

 cessitating an adequate form of restraint. The incision 

 throti|gh the skin, the dissection of the nerve, the elevation of 

 the nerve from the surgical wound, and the final division of 

 the nerve, constitute so many manipulations that are so 

 promptly and forcibly resented as to demand restraint or 

 anaesthesia or both. Depending upon the temperament of the 

 patient and the particular operation to be performed, either 

 the standing or recumbent position may be selected. Some 

 veterinarians recommend the recumbent position with com- 

 plete chloroform anaesthesia for all of the neurotomy opera- 

 tions, while others prefer the standing position with local co- 

 cainization for the plantar operations and the recumbent po- 

 sition with local cocainization for the higher and deeper oper- 

 ations. In this connection the practitioner should be guided 

 largely by certain circumstances. Median, tibial, peroneal, 

 and ulnar neurotomy require the recumbent position. The 

 standing position is unsatisfactory in some of them and ab- 

 solutely deficient in the others. Median neurotomy, for ex- 

 ample, can only be properly performed when the patient is in 

 lateral decumbency with the leg well stretched from the 

 body. The dissection in these deep operations is facilitated 

 greatly by the use of cocaine solution subcutaneously, imme- 

 diately before the operation begins. In the case of the plan- 

 tar operations either the standing or the recumbent positions 

 may be selected. If the horse is inclined to be gentle and the 

 operation is only to be performed upon one limb, the standing 

 position will often answer, but when the patient is restive or 

 when both limbs require the operation the recumbent posi- 

 tion will give the best general satisfaction. After one, two, 

 or three nerves have been dissected out and divided the pa- 

 tient will very often bcome so uncomfortably resentful as to 

 prevent further progress. Sometimes the restive state is due 



