DIGITAL NEUROTOMY. i55 



a short distance inferiorly it passes beneath 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 XXV or from the superior end of the first phalanx 

 down to a level with the superior border of the lateral carti- 

 lage, 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 disin- 

 fect 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 perpendicular to the skin, make an incision from above 

 downwards a distance of from 2 to 5 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 enveloping the nerve and artery. Pass an aneurism 

 needle beneath the nerve, and follow with a second one 

 immediately beside the first. 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 bistoury, or scis- 

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

 the wound and excise a section 3 cm. long. Disinfect and 

 bandage with or without suturing the wounds. lycave the 

 bandage in place 6 to 8 days. 



