ULNAR NEUROTOMY 



195 



it. The ulnar nerve lies beneath and slightly anterior to 

 the vein. It is never- deeply imbedded. Just beneath it is 

 the small tendon of the ulnaris accessoris, which might at 

 first be mistaken for it, but which is soon seen to be too 

 large. The ulnar nerve at this point is the size of a wheat 

 straw, and it is generally found by pushing aside the vein 

 with the dissecting forceps, or by carefully separating the 

 vein from its surrounding structure with the forceps and 

 scalpel. 



Fourth. Step. — Elevation of the Nerve. — The nerve is 

 elevated with the elevator, loosened along the course of the 

 wound, and then resected in the usual manner. 



Fifth'Step. — Closing the Wound. — The wound of ulnar 

 neurotomy is closed with two sets of sutures. Two mattress 



Fig. 108— Relations of the Ulnar Nerve, 

 a— Artery, b, b — Skin', n — Nerve, v— Vein. /, /—Fascia. 



sutures are first adjusted some distance from the edges of 

 the wound, and then several interrupted stitches are placed 

 along the edges to keep them in perfect apposition. In this 

 manner there is no friction of the edges, as the horse moves 

 about, and the union is primary. It is essential to'heal this 

 wound promptly, to prevent a muscle hernia. If the skin 

 edges gap, the underlying muscles (no longer supported by 

 the antibrachial fascia) protrude, delay cicatrization, and 

 finally leave an indelible blemish. 



AFTER-CARE. — The patient is kept in the standing po- 

 sition for ten days, or until the wound is safely united. The 

 lying posture would disturb the sutures and prevent their 

 union. 



