840 INFLAMMATION OF THE FLEXOR TENDONS. 



of this ligament is affected lameness may be absent. Lameness 

 is usually deferred until some hours after the strain. 



Lameness is only shown when weight is placed on the limb. 

 Attempts are made to shorten that phase of movement during which 

 the digit is in a position of volar flexion, i.e., is upright and under 

 the body. Neither passive extension nor rotation appear very 

 painful, a fact which distinguishes the disease in question from 

 disease of the joint. The symptoms then are, supporting leg 

 lameness, shortening of the period when the limb is upright, volar 

 flexion of the phalanx, and absence of pain when the limb is rotated. 



(2) Local examination detects pain, swelling, and increased warmth, 

 which latter, however, is only felt early in the disease, and even then 

 indistinctly. It is difficult to distinguish pain in the reinforcing 

 band of the flexor perforates (radial ligament), though it also 

 occasionally suffers. In applying pressure to the tendons, it is 

 important not to be deceived by mere general sensitiveness. 



The swelling varies in degree and extent, that accompany ing 

 strain of the flexor perforates or sub-carpal ligament being, in " clean " 

 legs, sometimes visible from a distance, and in other cases only to be 

 detected by palpation. At first it is soft and diffuse ; later it becomes 

 harder and sometimes sharply defined. In examining for pain and 

 swelling, the foot is lifted ; the reinforcing bands can only be properly 

 examined in this position. 



(3) The symptoms enumerated are afterwards followed by apparent 

 shortening of the diseased tendon, continuous volar flexion and 

 upright position of the hoof. This is differentiated from the volar 

 flexion produced by placing weight on the leg, by the fact that it 

 continues even when the animal stands fairly on the limb ; the point 

 is at once settled by lifting the other foot. Whilst contraction of 

 the flexor perforans produces volar flexion in all the lower joints, 

 contraction in the flexor perforates and suspensory ligament only 

 affects the obliquity of the pastern ; the hoof remains in its normal 

 position. 



In race-horses a large number of fasciculi of the flexor perforans 

 may be ruptured, producing abnormal dorsal flexion of the 

 phalanges and so-called "break-down." This is oftenest seen when 

 both limbs suffer, or when the animal is forced to stand continuously 

 on the diseased Limb. 



Similar stretching of the flexor tendons is sometimes seen after 

 neurectomy, performed whilst the tendons are inflamed. The ordinary 

 weight of the bodj may then cause stretching of the tendon, or of 

 the cicatricial tissue newly formed within it. Moller has seen this 



