TIBIAL NEUROTOMY 



183 



Second Step. — Disinfecting the Seat of Operation.— The 



hair is clipped from the groove with scissors ; the field is 

 then moistened and shaved. The shape of the region renders 

 this step somewhat difficult. The razor cannot be easily 

 carried into all parts of groove on. account of its sharp and 

 deep depression at the very point where the incision is to be 

 made. It will be found necessary to press the fingers into 

 the groove beneath and lift the parts upward before thor- 

 ough shaving is possible. The disinfection is completed by 

 rinsing the parts with the mercuric chloride solution. 



Fig. 102— Position of Incision in Tibial Neurotomy. (Bayer.) 



Third Step.— Making the Incision.-The incision is made 

 one and a half inches long at the point indicated first 

 through the skin with the scalpel and then through the 

 fascia with the probe-pointed bistoury, cutting upward and 

 outward in order to avoid wounding the posterior tibial vein, 

 which lies directly under the fascia, slightly anterior to the 

 line of the incision, but sometimes immediately under it. As 

 in median neurotomy, the probe-pointed bistoury is indis- 

 pensable. Otherwise, the vein, sometimes full and bulging, 

 will frequently be wounded and yield a troublesome haemor- 



