MEDIAN NEURECTOMY 
617 
fascia on either side, thus more freely uncovering the nerve. The skin 
wound is then held open with retractors. The next step in operation 
consists in dissecting free the nerve (sometimes a rather tiresome 
process), and raising it on a grooved director or tenaculum. The nerve 
is cut through as high up as possible, and again near the lower limit of 
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the wound, a piece about three-quarters of an inch in length being- 
removed. The operation is concluded by wiping the wound dry, dusting 
with iodoform, suturing the skin, and applying a little iodoform collodion 
or similar dressing. 
When the incision is skilfully made at the proper point, and the anti- 
brachial aponeurosis opened, the nerve often appears immediately as a 
flattened whitish cord, which has a tendency to become thrust forward 
