[Footnote A: Journal of Comparative Pathology and Therapeutics, vol. ix., p. 181.]
The nerve exposed, the remainder of the operation is exactly as that described in removing the portion of the nerve in the plantar operation. The wound is sutured and suitably dressed, and a fair amount of exercise afterwards allowed the patient.
F. LENGTH OF REST AFTER NEURECTOMY.
This is placed by the majority of surgeons at about three weeks to a month. Within that period no excessive exertion should be undergone by the patient. A certain amount of quiet exercise, however, is beneficial, facilitating the healing of the wounds, and accustoming the animal to the altered condition of his limb.
G. SEQUELÆ OF NEURECTOMY.
These we shall relate collectively, making no distinction between those following excision of the plantar nerve and those succeeding section of the median. It must be remembered by the surgeon, however, that the unfortunate sequelæ we are now about to describe are likely to be far more grave when following section of the larger nerve.
Liability of Pricked Foot going undetected.—On account of the warning they convey to the surgeon, first place among the sequelæ of neurectomy must be given to accidents following loss of sensation. Take, for example, punctured foot. In any case, in the sense of being unforeseen, it is accidental. In the neurectomized foot it becomes doubly accidental, in that not only is it unforeseen, but that it is for some time indiscoverable. With the foot deprived of sensation, a nail may be picked up, or a prick sustained at the forge, and no intimation given to the attendant until pus has underrun the horn, and broken out at the coronet. What follows, then, is that the hoof as a whole, or the greater part of it, sloughs off.
No neurectomy should be undertaken unless this contingency has been allowed for. The owner should be advised of it by the surgeon, who should at the same time enjoin on his client the absolute necessity of giving to the neurectomized foot daily and careful attention.
Loss of Tone in the Non-sensitive Area.—In addition to the mischief resulting from a wound going undetected, it must be remembered that the loss of tone resulting from the operation gives to every wound (however slight), in the region supplied by the removed nerve, a sluggish and troublesome character. Difficult to deal with as wounds about the foot ordinarily are, they are rendered more so by a previous neurectomy.
Gelatinous Degeneration. This is a condition liable to occur in cases where the operation has been too long deferred, and when considerable structural alteration has already taken place in the shape of diseased bone or tendon, more especially in navicular disease. It consists in a peculiar softening of the structures of the limb, accompanied with enlargement, due to swelling of the connective tissues, the enlargement and softening generally making itself first apparent by a soft, pulpy swelling in the hollow of the heel.