PERONEAL NEUROTOMY 187 



spected. It can only be defended as a last-resort operation. 

 A spavined horse may lame for one or two years and then 

 finally become useful during the remainder of a long life. Lf 

 this double operation is performed the complications which 

 are certain to follow sooner or later will shorten this period 

 of usefulness, because the sensibility of the foot and fetlock 

 is sacrificed to the ultimate detriment of the unnerved sub- 

 ject. It is at least an operation that the veterinary practi- 

 tioner can not well afford to recommend too highly. 



RESTRAINT. — Peroneal neurotomy is performed in the 

 lateral recumbent position with the affected leg uppermost. 

 The leg should be extended from the body rather than flexed 

 at the hock for the important purpose of bringing the anato- 

 mical structures separated in the operation into the same 

 relations they occupy when the patient is in the standing 

 position. If the operation is performed with the leg in a 

 cramped, unnatural position, it will be found that the su- 

 tured wound will be crimped and distorted when the patient 

 assumes the standing posture. The difficulty of healing the 

 wound of peroneal neurotomy, which is referred to below, 

 is guarded against at this, the first step of the operation, by 

 so arranging the leg that the structures will be separated in 

 their normal respective positions. 



The operating table is by far the best apparatus for the 

 operation, because a normal extension of the leg is main- 

 tained by simply fixing the foot to the table, and then fasten- 

 ing both legs together with a "figure eight" below the hocks. 

 Subcutaneous cocainization, in addition to these fastenings, 

 is sufficient restraint on the operating table. When the 

 casting harnesses are used, general anaesthesia is advisable to 

 assure the perfect immobilization of the region that is es- 

 sential to the execution of the rather difficult technique. 

 Local anaesthesia is hardly sufficient because at the crucial 

 part of the operation, — the elevation of the nerve, — a strug- 

 gle will often so change the relations of the muscles as to 

 hide the nerve that was previously visible in the depths of the 

 wound. The English hopples are fairly satisfactory. With 

 the aid of general anaesthesia the operation can be performed 

 without even releasing the leg from the hopples. 



Whichever apparatus is used the one point to respect is 

 the fixation of the leg in the extended position. 



EQUIPMENT.— Scalpel, probe-pointed bistoury, dis- 

 secting forceps, three or four artery forceps, two tenacula 

 for wound retractors, a special nerve elevator (Fig. 105), 

 needles and thread, cocaine solution, antiseptic solutions, 



