186 VETERINARY SURGICAL OPERATIONS 



muscles, about three-quarters of an inch from the surface of 

 the skin, and but a short distance from the anterior tibial 

 artery. Approaching the hock it directs its course internally 

 until it gains the antero-internal part of the tarsus, where it 

 sends ramuscules into the midst of the tarsal bones. One of 

 its branches accompanies the perforating pedal artery into 

 the depth of the articulations, the other, the terminal branch, 

 continues down the anterior aspect of the leg to be lost cu- 

 taneously along the metatarsus. This nerve has a pro- 

 nounced influence on the sensory innervation of the seat of 

 spavin, but is not alone in supplying sensation to the hock. 

 It is largely concerned in distributing sensation to the cunei- 

 form bones. 



INDICATIONS. — Peroneal neurotomy has heretofore 

 been applied in conjunction with tibial neurotomy for the 

 relief of spavin lameness. It has never been recommended 

 ajone for this or another purpose. Recently, however, in nu- 

 merous trials, we have applied it with phenomenal success in 

 circumscribed spavin, located in the usual position, after re- 

 peated blisters, firing, — feather and puncture, — and cunean 

 tendinotomy had failed to afford relief. In fact, this is its 

 real indication. It should be used alone, for circumscribed 

 spavin after the inflammatory stage has been made to yield 

 more or less to the old lines of treatment. 



A spavin has been fired, probably, twice, it has been blis- 

 tered, cunean tendinotomy has been performed and the lame- 

 ness persists. At this time, the disease being local peroneal 

 neurotomy alone may be safely recommended as a positive 

 cure for the lameness. It seldom fails. When the inflamma- 

 tion is new, spreading, encroaching, active, the same bene T 

 fits are not obtained. When the spavin is diffused over a 

 wide region, implicating nearly all of the tarsal bones, even , 

 if the condition is old and the lameness trivial, very little 

 benefit is derived. In fact, in such cases there is no percepti- 

 ble change in the lameness after the operation has been per- 

 formed. In these 'diffused cases tibial neurotomy must be 

 performed in addition to the peroneal operation, and even 

 then relief is not certain, particularly if the tibio-astragular 

 articulation is implicated. A spavin involving the major 

 part of the tarsus is not affected by peroneal neurotomy, and 

 is not always cured when both operations are performed. 

 When the true hock joint is involved no relief seems possi- 

 ble, from any neurotomy. 



The double or tibio-peroneal operation has, therefore, a 

 limited sphere of usefulness, if the above presents are re- 



