168 VETERINARY SURGICAL OPERATIONS 



nerve, that have proven to be absolutely refractory, are the 

 only indications considered by the cautious practitioner. A 

 hurried resort to median neurotomy should be avoided, 

 because other methods — firing, blistering, etc., may deter- 

 mine a better result, a more lasting cure. 



The operation is, however, riot without its redeeming 

 features. In fact, it has a sphere of usefulness in cases of 

 lameness where chronicity and diffusion of the lesions render 

 other lines of treatment ineffectual ; where the lameness, 

 in spite of everything, persists; where the subject is deemed 

 worthless. It sometimes occurs that horses have a com- 

 bination of diseases along the course of the leg. Thus nav- 

 icular arthritis may be complicated with lesions in the bones, 

 synovials and tendons as far upwards as the carpus. When 

 such an aggregation of lesions continue to cause lameness 

 after the usual palliative methods of treatment and have 

 failed to yield entirely to digital neurotomy, very often 

 median neurotomy will promptly give a satisfactory degree 

 of relief. The acme of its value is reached in this particular 

 instance. When the operation is performed for a definite 

 lesion; wherever located, it usually fails to bring the desired 

 effect, except in certain lesions about the fetlock, or when 

 accompanied with ulnar neurotomy. 



Osteophytes located on the internal aspect of the os suf- 

 fraginus, after having resisted the usual treatment' of firing, 

 blistering and rest, require the operation in lieu of any other 

 treatment. In these cases a lasting benefit is sometimes 

 derived, but when the lesion occupies an external position or 

 extends across the entire bone, the benefit is only a partial 

 amelioration of the lameness. Periosteal inflammations 

 often produce osteophytes at different points of the legs, on 

 the os suffraginus, on the metacarpus, or in the region of the 

 splint bones. These may or may not implicate the articu- 

 lations. When such abnormalities are non-articular and 

 located on the internal aspect of the leg, median neurotomy 

 will effectually, and often permanently, dispatch the lame- 

 ness resulting from them. On the other hand when lo- 

 cated externally, or when transgressing upon the ginglymoid 

 articulations, the operation is ineffectual or dangerous. 



Tendinitis.- — The circumscribed lesion of the tendons of 

 draft horse located at the level of the upper third of the 

 metacarpus due to severe traction-strain or rupture, and 

 manifested by a painful tumefaction, lameness and volar 

 flexion that often persists after firing and rest, has been 

 from the start, regarded as the chief indication for this oper- 



