DIGITAL NEUROTOMY. 133 



of the first phalanx the nerve lies in front of this ligament, 

 a short distance inferiorly it passes belieath it, while from 

 the middle of the pastern downwards the nerve lies behind 

 the ligament. 



The operation is practicable at any point over the line of 

 the nerve from the top to the bottom of the shaved area in 

 Plate XX or from the superior end of the first phalanx down 

 to a level with the superior border of the lateral cartilage, 

 but perhaps preferably at about the middle of the pastern. 

 At the desired point and over the groove between the flexor 

 pedis tendon and the phalanges shave and disinfect an area 

 4 to 5 cm. square. In the center of this area at the anterior 

 border of the flexor tendon, with the scalpel held perpen- 

 dicular to the skin, make an incision from above downwards 

 a distance of from 2 to 3 cm. cutting cleanly through the 

 skin and subcutaneous fascia down upon the nerve. The 

 incision is favored by tensing the skin between the thumb 

 and index finger of the left hand, but care should be taken 

 not to displace it backwards or forwards. Dilate the wound 

 by pressure with the thumb and index finger or otherwise 

 and carefully incise longitudinally the fibrous sheath en- 

 veloping the nerve and artery. -Pass an aneurism needle 

 beneath the nerve, and follow with a .second aneurism needle 

 immediately beside the finst. Draw, the two apart, one 

 toward the toe, the other toward the fetlock, and separate 

 thereby the nerve from the surrounding tissues. Remove 

 one aneurism needle, insert a probe pointed scalpel, or scis- 

 .sors beneath the nerve, and divide it at the upper angle of 

 the, wound and excise a section of nerve 3 cm. long. Diijiu- 

 fect and bandage with or without -suturing the wounds. 

 Leave the bandage in place 6 to 8 days. 



