ANTERIOR TIBIAL NEUROTOMY. 163 



by a large amount of adipose tissue. Cut through this fat 

 and coiiuective tissue aud the tibial nerv£, «, Plate XXV and 

 NS, Plate XXVII, is in sight, immediately before it lies the 

 plantar vein and on the lateral side is situated the recurrent 

 tibial artery SA, Plate XXVII. The cross section in Plate 

 XXVH is located .somewhat below the point for operation 

 and the vein has cro.ssed obliquely over the nerve so that it 

 appears behind instead of in front of it, as is the case gen- 

 erally at the point where the operation is perfornied. Sep- 

 arate the vessels completely from the nerve with the handle 

 of the scalpel, pass two aneurism needles from before back- 

 ward beneath it and drawing these apart separate the nerve 

 trunk from the adjacent tissues and cut it off at the upper 

 and lower angles of the wound removing a section at least 

 5 cm. long. Suture the cutaneous wound and apply a 

 bandage allowing it to remain eight days. Healing by first 

 intention. 



40. ANTERIOR TIBIAL NEUROTOMY. 



Neurotomy of the Deep Branch of the Peroneal Nerve. 



Plates XXVI and XXVII. 



Object. An adjunct operation to the preceding as it sup- 

 plies sensation to the tarsus in common with the sciatic. 

 The two constitute what is known as Bossi's double neuro- 

 tomy for spavin. 



Instruments. Same as in the preceding. 



Technic. Confine as in the preceding but with the 

 affected leg uppermost. L,ocate the furrow dividing the ex- 

 ten.sor pedis lougus mu.scle, EP, Plates XXVI and XXVII, 

 and the peroneus muscle, P, Plate XXVI, MP, Plate XXVII, 

 and shave and disinfect the .skin over an area 6 cm. long by 

 3 cm. wide directly over this depre.ssiqn and extending up- 



