Amputation of the claw or op the two last phalanges. 



'31 



necrosis of the bones, suppurative synovitis, and even suppurative 

 arthritis of the second and first inter-phalangeal joints. 



If carefuH}^ treated these forms of arthritis may disappear, leaving 

 the joints anchylosed, but unfortunately the application of the 

 necessary antiseptic injections (free injection with warm boiled water, 

 injection of 10 per cent, iodised glycerine, 3 per cent, carbolic glycerine 

 or "1 per cent, sublimate) is difficult and costly. 



It is better, in such cases, to remove the claw or the two last 



Fig. 296. — Anatomical relations of 

 the inter-phalangeal joints. 



Fig. 297. — Disarticulation of the 

 claw and third phalanx. 



phalanges. With antiseptic precautions the stump heals, and recovery 

 takes place ^Yitllout the interminable suppuration and pain which 

 otherwise cause such grave loss of condition. 



(1.) Disarticulation of the Claw and Third Phalanx. — The 

 patient is cast and suitably fixed. The horn-secreting coronary band 

 of the claw must be preserved. 



First stage. The horny wall immediately beneath the coronary band 

 is thoroughly thinned and the tissues are divided as far as the bone. 



