828 WOUNDS AND BRUISES OF THE METACARPUS. 



internal small metacarpal bone, where a subcutaneous hsematoma 

 is often produced. 



Treatment. Recent wounds require the strictest antisepsis. In 

 many cases, iinfortuntely, they are already infected by the wounding 

 agent, or by the bandages applied to check bleeding, but can 

 generally be efficiently disinfected, even twelve to twenty-four hours 

 after injury. Bleeding must be checked by styptics, torsion, or 

 by ligature. The limb must then be carefully washed with soap 

 and water, the wound and its surroundings rinsed with sublimate 

 or carbolic solution, all foreign bodies removed, and the wound 

 douched with a powerful stream of antiseptic fluid. If asepsis seems 

 possible, the w r ound, and even the ends of the tendon, should be 

 sutured, and an antiseptic dressing applied, and renewed as may 

 be required. Provided it is not sodden with blood or wound dis- 

 charge, the dressing is left in position until the animal begins to 

 place weight on the limb, or the wound is healed. 



Failing asepsis, necrotic portions of tendon must be excised, 

 and excessive proliferation of tissue around the wound checked by 

 moderate compression. Necrotic portions already partially separated 

 can be removed with the scissors or knife. Over-prominent granu- 

 lations may be checked by astringents, such as tannoform, 

 tannin mixed with iodoform, or by dried alum in powder ; a well- 

 fitting pressure dressing serves the same purpose. Sometimes new 

 growths may require to be removed with the knife or cautery. All 

 such surgical wounds must be kept very clean to prevent infection. 

 During treatment the patient should be rested in slings. 



Where the tendon sheath is also injured, extreme attention must 

 be given to antiseptic precautions. Exudate or pus is apt to distend 

 the lower portion of the sheath, and drainage must be provided by 

 a counter-opening. Reported cases show that careful antisepsis 

 may secure healing even in severe injuries of tendons and tendon 

 sheaths. 



Bruising of the metacarpus, due to "speedy cutting," kicks, 

 &c, often causes formation of haematoma or hygroma of the size 

 of a walnut, or hen's egg. If soon opened troublesome bleeding 

 may result ; on the other hand, absorption takes a long time, 

 particularly in injuries about the head of the inner small metacarpal. 

 Lameness is rare, and animals can be worked, whilst reduction of 

 swelling is encouraged by continuous compression and daily 

 massage. If, in valuable horses, operation be attempted, strict 

 antisepsis must be observed, for pus formation may be followed 

 by subfascial cellulitis and troublesome complications. 



