NEURECTOMY

(UNNERVING)
 DEFINITION
• Neurectomy is the division and removal of a
piece of nerve as a palliative last resort
measure to prolong the utility of working
animal in incurable, aseptic, chronic
inflammatory lesions without serious
structural altercations.
 INDICATIONS
• Splints
• Ring bone
• Navicular disease
• Laminitis
• Canker of the foot
 ANAESTHESIA AND CONTROL
• General anaesthesia
• If deep anaesthesia is not obtained a local
analgesic is in addition injected around the
nerve before cutting it.
 TECHNIQUE
• The nerve is situated striated longitudinally and has
pale grey colour.
• The nerve can be stretched far outside the wound
and when released it may remain limp in the
incision.
• The pulsation and pinkish colour will differentiate an
artery from the nerve
• A vein has bluish or purple colour
• The nerve is first divided proximally and then distally
 Neurotomy Needle

Neurotomy Needle and Knife combined

1, Median neurectomy. 2, Neurectomy of the ulnar nerve. 3, Tenotomy of deep flexor tendon.
4, High plantar neurectomy. 5, Low plantar neurectomy. 6, Cunean tenotomy.
 DISADVANTAGES
• Oedema may be caused shortly after neurectomy
• Degenerative changes causes shedding of the hoof
• Traumatic injuries may be caused
• Wound in affected region may take a long time to
heal
• A nodular enlargement called “amputation
neuroma” may be formed at the proximal cut end
of the nerve
 POST-OPERATIVE CARE
• Massaging of the region to promote quicker
establishment of collateral circulation
NEURECTOMY OF THE FORELIMB
 MEDIAN NEURECTOMY
• 1” below the medial radial tuberosity groove
between posterior border of radius and flexor
carpi radialis

1, Median nerve
2, Brachial artery
3, Brachial vein
4, Ante-brachial fascia
 ULNAR NEURECTOMY
• 4” above the line joining point of elbow and
pisiform in the groove between flexor carpi
ulnaris and lateralis muscle (Nerve is
superficial)
NEURECTOMY OF THE HINDLIMB
 ANTERIOR TIBIAL NEURECTOMY
• 2” below and behind the lateral tuberosity of
tibia in the groove between long digital
extensor and lateral digital extensor muscle
 POSTERIOR TIBIAL NEURECTOMY
• 4” above the point of hock and ½” infront of
gastrocnemius tendon
 POSTERIOR
(PALMAR / PLANTAR)
DIGITAL NEURECTOMY
 INTRODUCTION
• Posterior digital nerve is the branch of medial
volar nerve.
• It descends behind the digital artery
 INDICATION
• Navicular syndrome
• Chronic osteo-periostitis of the os pedis
• Plantar neurectomy is more satisfactory but
separation of hoof which sometimes ensures
high plantar neurectomy in rare after digital
neurectomy
 ANAESTHESIA AND CONTROL
• Tranquilisers are given prior to surgery and
surgery is to be done in standing position
• Nerve block at the level of proximal sesamoid
bones
• Apply no twitch
 SITE
• Upper third of posterio-lateral aspect of os-
suffraginis
 TECHNIQUE
• Scrub the site and apply antiseptic
• The foot is elevated and held by an assistant
• Incision to skin and fascia is made at the anterior border of the
superficial tendon
• The ligament of the ergot is usually encountered and pushed
aside
• The nerve is found slightly deeper and posterior to artery
• Nerve is elevated by traction with a neurectomy hook or,
mosquito forceps
• Remove a 1-2 cm piece of nerve
• Skin is closed with 1 or 2 interrupted absorbable suture
The pull-through technique for performing a PD neurectomy. Small skin incisions are made
distally and proximally in the pastern region and the PD nerve is transected distally and pulled
through the proximal incision
 POST-OPERATIVE CARE
• A sterile pressure bandage is applied in place
for 3 to 7 days
• A horse is to be rested for 4 to 6 weeksa
THE END