716 OPERATIONS ON THE FOOT. 



These fibro-cartilages are generally more developed in the an- 

 terior than the posterior extremities. They also j)resent, in one 

 foot, this slight difference, that the internal stands a little higher 

 than the external. 



Cartilaginous quittor is a serious affection, characterized by 

 the partial caries of one of the fibro-cartilages ; it is a partial gan- 

 grene whose character is to slowly spread into the cartilaginous 

 structure upon which it starts. To be treated with success, it re- 

 quires a very regular attendance, and often an operation, which 

 consists in the removal of the cartilage. Sometimes this opera- 

 tion is indispensable, and its study is interesting, especially be- 

 cause, though not as commonly performed as at the beginning of 

 this century, it is one which requires a high degree of surgical 

 skill for its success. 



I. Symptoms. — A division has been made of an acute and 

 chronic form of this disease. Under the first name, is considered 

 the earlier period of the affection, that in which there is inflam- 

 mation of the cartilage and painful swelling of the part, and when 

 the caries or necrosis of the fibro-cartilage is not yet estabhshed; 

 or if there is a wound, when it does not yet granulate, and the 

 suppuration, if it exists, is very slight. Chronic javart would be 

 that in which the partial and progressive mortification of the 

 fibro-cartilage exists ; for, as Kenault has said, it is the ordinary 

 termination of fibro-chondritis. 



When free from serious compHcation, the disease is generally 

 accompanied with but little lameness ; sometimes there is almost 

 none, and animals can be kept at work, esj)ecially at a slow gait; 

 but if made to trot, the horse will show lameness. It is especially 

 when the quittor exists in the posterior parts, that the inflamma- 

 tion and the pain are not excessive, because there is then an 

 abundance of soft, fatty tissue. But when the caries is more for- 

 ward, and is situated more deeply, in a point nearer the articular 

 surface, the lesion then affects the fibrous tissues and the pain is 

 greater. It is sometimes excessively acute. 



Upon the lateral part of the coronet, toward the heels or the 

 quarters, more or less tumefaction appears, more or less painful, 

 according to the duration of the disease, and in this case more 

 or less indurated. In the centre there exists a granulating fistu- 

 lous wound. There are one or several fistulfe (Figs. 524, 525, 526) 

 whose openings show granulations, bleeding easily, their course 



