NEUROTOMY OF THE ULNAR NERVE. 147 



the lower part of the carpus, covered by the tendon of the 

 obhqiie flexor becomes the lateral plantar nerve, neurotomy 

 of the median nerve does not completely effect the desired 

 end. In order to produce complete anaesthesia, therefore, 

 from median, it is necessary at the same time to perform 

 ulnar neurotom3'. 



38. NEUROTOMY OF THE ULNAR NERVE. 

 Plates XXIII and XXIV. 



Objects. An adjunct operation to the preceding by 

 which the enervation of the carpus and foot is completed. 



Instruments. Same as in the preceding. 



Technic. Above and Ijeliind tiie carpus there may be 

 felt a groove between the external and middle flexors of the 

 carpus, EF and OF, Plate XXIV. At this point 10 cm. 

 above the pisiform bone the skin is shaved and disinfected 

 and an incision 6 cm. long made through the skin and 

 antibrachial fascia. Tliis inci.sion exteiids just outside the 

 median line of the jiosterior surface of the radius in such a 

 way that the superior angle of the wound is about i cm. 

 farther outward than the lower. Beneath the fascia between 

 the aforesaid mu.scles is seen the ulnar nerve, Plate XXIII, 

 n, Plate XXIV, NU, on the median or inner side of it 

 the collateral ulnar vein, Plate XXIII v, and between the 

 two and .somewhat deeper the collateral ulnar artery, a. 

 The nerve, about 3 mm. in diameter is picked up with the 

 aneurism needle, severed at the upper and lower angles of 

 the wound, the lips of the wound united by a continuous 

 suture and a bandage applied. Healing by first intention. 



