1034 



DISEASES OF THE METATARSUS. 



SH 7 ---"$ 



For this reason prognosis is favourable, though the condition itself 

 may prove extremely obstinate. Success sometimes follows repeated 

 evacuation of the contents every three or four weeks. The operation 

 is not without danger, and Moller lost a horse from infective inflamma- 

 tion of the tendon sheath. Line firing may diminish, though it 

 seldom completely removes, the swelling. 



(d) The tendon sheaths in the metatarsal and phalangeal regions 

 become distended in a similar way to those 

 of the fore limb, though the bursa of the 

 extensor pedis, which lies in front of 

 the fetlock -joint, is more often affected than 

 in the fore limb. It gives rise to a well 

 marked, sometimes bilobular swelling, which 

 may attain the size of a child's head, and 

 though it does not always cause lameness, 

 greatly impairs the animal's appearance, 

 and sometimes leads to inflammation of the 

 skin, or even to abscess formation. These 

 swellings usually contain large quantities 

 of fibrinous clot, which, however, cannot be 

 detected by palpation. This explains why, 

 in old-standing cases, neither blistering nor 

 firing, nor even extraction of the fluid con- 

 tents and injection of iodine solution, is 

 successful, and why operation and removal 

 of the organised contents are alone of use. 

 Such operation is quite safe, even when 

 suppuration occurs. Recovery follows, after 

 strict asepsis, though considerable thickening 

 may be left. When the swelling is extensive, 

 a portion of the distended bursa and skin 

 covering it may be removed, the edges of 

 the wound brought carefully together, and a compress dressing 

 applied (see also vt Treatment of Enlarged Synovial Cavities in the 

 Fore Limb "). 



Frick saw a peculiar affection of this bursa. The primary swelling and 

 thickening of the walls of the bursa were unaccompanied by pain. Sup- 

 puration followed, and a chocolate-coloured, thin, fluid pus, containing 

 white flocculi, was discharged. Slight lameness was then shown (supporting 

 leg lameness), and the granulations which surrounded the wound became 

 rather exuberant. As the wound obstinately refused to heal the horse 

 was killed. On post-mortem examination the bursal cavity was found 

 to communicate with the fetlock- joint. Both contained turbid, chocolate- 



Fig. 553. — Distension of 

 the metatarsophalangeal 

 (sesamoid) sheath. 



