OPERATION FOR PICKED-UP NAIL. 453 



carbolic solution, and a fresh gauze drain inserted. Next day less 

 weight was placed on the foot, but no general disturbance was noted. 



From the 12th improvement was rapid. The dressing was renewed 

 every week, the thickness of the gauze drain being diminished. 



On the 28th drainage was suspended, a shoe was applied, and a 

 dressing kept in position by splints inserted. The horse showed little 

 lameness when walking. 



Left hospital on the 7th November, and returned to light work a 

 few days later. 



157. A five-year-old entire horse, suffering from picked-up nail in 

 the left hind foot, entered hospital March 5th, 1898. Three weeks 

 before an operation had been performed by a veterinar}- surgeon ; the 

 wound had become sinuous. 



Condition on Entry. — Lameness was very marked, the foot resting 

 on the toe. There was frequent stabbing pain ; the limb was swollen 

 as high as the hock, and the coronet enlarged, especially at the back, 

 and in the flexure of the pastern. 



The dressing covering the lower surface of the foot was removed. The 

 woundoccupiedthemiddlezoneof the external lateral lacuna; its margins 

 were greatly swollen and vegetating, and discharged purulent synovia. 



Treatment. — Disinfection of the foot and wound ; carbolic baths ; 

 application of a moist dressing. Next morning the horse was found 

 sitting up like a dog, with the hind limbs extended under the body. It 

 was assisted to rise. 



After casting the animal on the table the complete operation for 

 picked-up nail was performed. The external half of the plantar apo- 

 neurosis {i. e. the expanded terminal portion of the flexor pedis per- 

 forans tendon) was necrotic to a point level with the posterior margin 

 of the navicular bone, which had been penetrated close to its anterior 

 border. At that point was a splinter of bone, which was removed 

 with forceps. The navicular joint had been opened, the interosseous 

 ligament detached from the navicular bone, and the inferior synovial 

 ad-de-sac perforated. After touching th© articular wound with tinc- 

 ture of iodine the parts were irrigated with warm 2 per cent, carbolic 

 solution, covered with iodoform, and plugged with gauze. The foot 

 was surrounded with a cotton-wool dressing. 



During the next two days pain was acute. Temperature 39"o° to 

 39-6° C. 



On the 9th the dressing was removed, the wound cleansed with an 

 antiseptic solution and covered with a fresh iodoform dressing. 



From the loth to the 17th the general condition remained good. 

 The fall in temperature, diminution in frequency of stabbing pain, 

 lessened swelling, return of appetite, and ability to stand, all showed 

 that the wound was healing without complication. 



On the i8th the dressing was renewed. The coronet was slightly 

 swollen, the parts were granulating throughout. The articular wound 

 had healed. 



On the ist April a shoe and splint dressing were applied. A week 

 later exercise was commenced. ' 



