154 VETERINARY SURGICAL OPERATIONS 



SEQUELS AND ACCIDENTS.— Operative and pos'- 

 operative accidents are more numerous from high plantai 

 than from any of the other neurotomy operations. It wa^ 

 this operation that brought "nerving" into disrepute during 

 previous epochs, and in many communities at the present 

 time, but these need no repetition here, having been dis- 

 cussed at length in a previous paragraph under "Neurot- 

 omy." The most common unfavorable termination, de- 

 scribed under the head "Breaking down of the diseased un- 

 nerved structures" follows in the wake of this operation with 

 uncomfortable frequency. Unless all of the recommenda- 

 tions governing the selection of suitable cases, and unless all 

 of the post-operative precautions are respected, high plantar 

 neurotomy will prove more of a bane than a blessing to the 

 veterinary practitioner and his clients. This sequel occurs- 

 in both an acute and a chronic form. In the former, it some- 

 times presents itself before the surgical wound has healed, 

 or as soon as subject is returned to work, and may be mani- 

 fested by wrenching of the plantar aponeurosis from its at- 

 tachment, followed by turning up of the toe or by a rapid 

 shedding of the hoof after two or three days of tumefaction 

 around the coronary cushion. In the chronic or delayed 

 form its encroachment is gradual, appearing first in the form 

 of a tumefied, painless condition of the tendons above the 

 hoof, and ending either in a severe lameness , with volar flex- 

 ion of the fetlock, or in only slight lameness with a gradually 

 developing dorsal flexion of the same articulation. A de- 

 layed break-down is sometimes seen to follow the. accidental 

 wounds previously mentioned. 



Among the accidents sometimes occurring during the 

 operation is the accidental opening of the superior cul de sac 

 of the sesamoidean synovials. This occurs during the dis- 

 section, as the result of a careless wielding of the scalpel or 

 from a sudden jerk of the improperly restrained leg. It is a 

 harmless incident if infection does not enter into the situa- 

 tion, at the time or during the healing of the wound. 



Bilateral Digital Neurotomy. 



SYNONYMS.— Low plantar neurotomy; digital neurot- 

 omy; the low operation. 



DEFINITION.— Bilateral digital neurotomy is the sur- 

 gical division of the posterior branches of the plantar nerve 

 a short distance below the level of the metacarpo-phalangeal 

 articulation. 



