THE TREATMENT OF PICKED-UP NAIL. 61 



tically stationary, any change, however, being towards improvement. 

 The temperature never rose beyond 39"3^C. (1027° F.). On the eighth 

 day more weight was placed on the foot, and the lancinating pain had 

 disappeared. The dressing was removed. To loosen the gauze which 

 adhered to the deeper parts, the foot was placed in warm carbolic solu- 

 tion. There was only a little reddish discharge ; the wound appeared 

 very healthy and granulations were everywhere springing up, except on 

 the navicular bone and in the stump of the perforans tendon, where 

 preparations for granulation were seen. After thorough cleansing, the 

 parts were again covered with a cotton-wool dressing. 



On the tenth day the patient's condition was excellent; fever had 

 ceased, and weight began to be placed on the affected limb. On the four- 

 teenth day the dressing was renewed. The layer of gauze was moist ; the 

 wound, which contained a little pus. was entirely covered with granula- 

 tions. A thin shoe was applied, with four nails, and the surgical 

 dressing fixed in position with splints. 



After the eighteenth day improvement occurred rapidly. The animal 

 still walked lame, but placed more weight on the leg. Exercise was 

 commenced, night and morning. A week later the wound was about 

 three quarters healed, and the lameness scarcely noticeable at a walk. 

 Twenty-four days after operation the mare was able to do a little work. 

 She did not leave hospital, however, for another week. At that time 

 lameness was scarcely perceptible when walking. 



It may be said that, of course, this injury was in a hind foot, and 

 that injuries to fore-feet are graver, and treatment would be more pro- 

 longed. But two months after this case I operated in the same way 

 on another horse, which had picked up a nail in the off fore-foot. The 

 case was also complicated with necrosis of the aponeurosis and with 

 purulent synovitis. The result was as favourable as in the preceding 

 instance, and the period of treatment not much longer. The horse, in 

 fact, returned to work in five weeks. A little later the then existing 

 lameness had completely disappeared. 



By preserving the larger portion of the plantar cushion not only is the 

 period of healing diminished, but the volume and area of the mass of 

 resulting cicatricial tissue are reduced. This cicatricial tissue often 

 remains excessively sensitive, keeping up lameness even where there is 

 no periostosis or marked swelling about the coronet. The more you 

 preserve the plantar cushion, the smaller will be the cicatrix and the 

 more certain and complete the result of treatment. 



On this first point, I may remark, it is not always necessary to 

 divide the plantar cushion perpendicularly to the long axis of the foot, 

 as you usually do in the animals provided for exercises in practical 



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