96 THE SURGICAL ANATOMY OF THE HORSE 



wound heals from the bottom by the formation of granulations. When 

 this new tissue reaches the level of the surrounding skin, to prevent 

 excessive granulation with a resultant "big" knee, the surface of the 

 wound is dressed with weak astringent lotion (e.g., sulphate of zinc and 

 acetate of lead). The bandages are now removed and a knee-cap is 

 applied, between which and the surface of the wound is placed a pad of 

 tow. This is to protect the surface of the wound, for since the latter at 

 this stage is very irritating, the animal is very liable to strike it against 

 the manger or some such projection. The above method of treatment 

 has been found most effective in a district where serious cases of broken 

 knees are very common. 



When the knee is tightly and properly bandaged, as a rule the animal 

 will make very little effort to flex the joint, so that the healing process is 

 not disturbed. As a further preventive against this, however, a splint is 

 occasionally applied to the back of the joint in the manner already 

 described in dealing with bumped knee. 



Should the tendons be lacerated, any ragged edges should be removed, 

 otherwise necrosis is a likely consequence. 



In cases where one of the carpal articulations is plainly open and 

 suppuration has set in, consideration should be given as to the advisability 

 of treatment, as a common sequel is a stiff knee. This particularly 

 applies to the radio-carpal and intercarpal articulations, since in these the 

 greatest range of movement exists. In suppurative arthritis other 

 symptoms usually make their appearance. The knee is held with a slight 

 degree of flexion, the patient is usually very restless, the appetite 

 disappears and flesh is lost rapidly. These are accompanied by an 

 elevation of temperature. 



Where the case has been seen early suppuration can usually be 

 attributed to inefficient cleansing in the first instance. Too great im- 

 portance, therefore, cannot possibly be attached to this preliminary part 

 of the treatment. 



