MEDIAN NEUROTOMY 169 



ation. Peters, Pellerin, Harger, Adams and others have rec- 

 ommended it for this condition during the earliest days, of 

 its history. Their attitude toward it today is not known to 

 the author. 



In nearly every case the benefit is only a partial relief 

 of the lameness; sometimes the relief is scarcely perceptible, 

 while at other times a satisfactory degree of amelioration is 

 obtained. In short, median neurotomy is far from being a 

 pronounced success in curing the lameness accompanying 

 draft-horse tendinitis. 



For the "bowed tendon" of the race horse, whether lo- 

 cated at the lower third or the middle third of the metatarsus, 

 metlian neurotomy cannot be recommended in the horse in- 

 tended for racing purposes, although quite effective when 

 the horse is given but slow work thereafter. The unnerved 

 "bowed tendon" will not long withstand the severe strain to 

 which it is subjected in racing. Firing and blistering is a 

 much better treatment, all things considered. 



Carpal synovitis or carpal osteitis (knee spavin) is sel- 

 dom sufficiently benefited to warrant a further recommenda- 

 tion of the operation in their treatment. The knee struc- 

 tures receive innervation from other nerves and from 

 branches originating above the seat of operation. Purely 

 carpal inflammations must, therefore, not be submitted to 

 median neurotomy with the expectation of relief from the 

 pain and lameness they produce. 



Ringbones, after having been treated unsuccessfully by 

 the usual palliative treatments, are suitable indications in 

 very many instances. Here median neurotomy is preferable 

 to the high plantar operation because the entire nerve sup- 

 ply is not cut off from the seat of disease. The ulnar nerve, 

 through its plantar fibers, still preserves some of the sen- 

 sation, and thus leaves the parts less exposed to injury, but 

 prevents a complete cure of the lameness. Often however, 

 the benefit is ample, in that the subject is made more service- 

 able. The ringbone that is confined largely to the internal 

 aspect of the digital bones is the ideal one, especially if old 

 and if no longer in the siege of an active inflammatory proc- 

 ess. It is preferable that the bony deposit has already ob- 

 structed the motion of the articulation. A bony prong or 

 two transgressing upon a joint without mechanically limit- 

 ing its motion will grind into the surrounding soft structures 

 and promptly cause a serious incurable disturbance in the 

 latter, when sensation has been banished from the region. 

 Thus new ringbones or the rather trivial periarticular oste- 



