BILATERAL AND- UNILATERAL PLANTAR NEUROTOMY 145 



that will yield to no other treatment then the division of the 

 nerve on the affected side. However, these cases are more 

 effectually reached by the medium and the ulnar operations 

 than by plantar. The latter nerve is somewhat too near the 

 seat of disease to account for all of its innervation. 



CONTRA-INDICATIONS.— The contra-indications for 

 plantar neurotomy have already been mentioned under 

 general contra-indications for neurotomy. It might, how- 

 ever, be advantageously repeated here that the operation 

 is positively dangerous under many circumstances. Too 

 often it is followed by casting of the hoof, or wrenching of 

 the tendons and ligaments of the pedal articulations, to -\v"ar- 

 rant a too liberal recommendation under any circumstances. 

 In pronounced lameness of navicular disease, in any recent 

 acute disease process or in subjects with weak, flat, deformed 

 feet, its exclusion must be made an absolute law. Plantar 

 neurotomy is an operation to be recommended with great 

 caution. The practitioner must use the greatest discretion 

 in the selection of every case, and the owners should always 

 be made cognizant of the possible disastrous results. To 

 fail in this is to invite discredit. Chronic laminitis, recent 

 ringbones and acute navicular disease are the three principal 

 conditions in which the operation is most likely to be mis- 

 applied. Feet affected with serious corns, especially those 

 which have suppurated or threaten to suppurate, are likewise 

 unwelcome subjects, whether they are causing lameness or 

 not. In fact, the foot itself, aside from the disease for which 

 the operation is to be performed, must be known to be sound 

 and strong, and in no way predisposed to new dangers ; 

 otherwise it must be considered as a contra-indication. 

 Weak hoofs, hoofs with rough, friable horn, hoofs affected 

 with serious corns, cracks, seedy toes, or convex soles are 

 sufficient reasons to exclude neurotomy in every instance. 

 Another undesirable condition is the pastern that slopes be- 

 low the normal angle in aggravated dorsal flexion. The 

 straight pastern is much more favorable for neurotomy than 

 the one excessively sloped ; although the former will some- 

 times favor stumbling, the latter creates a greater suscepti- 

 bility to degeneration. 



Plantar neurotomy is always contra-indicated in the hard- 

 worked horse. The nerved horse that is slammed recklessly 

 along the stone-paved streets will never survive the opera- 

 tion for many months, and precisely the same may be said of 

 the horse occupied in pulling very heavy loads, and the one 

 engaged in racing or in very fast road work. While these 



