FRACTURES OF BONES OF THE FOOT. 327 



FRACTURES OF THE SECOND PHALANX (CORONET). 



Though these are generally of the comminuted kind, there are often 

 conditions associated with them which justify the surgeon in attempt- 

 ing their treatment. Though crepitation is not always easy to detect, 

 the excessive lameness, the soreness on pressure, the inability to carry 

 weight, the difficulty experienced in raising the foot, all these suggest, 

 as the solution of the question of diagnosis, the fracture of the coronet, 

 with the accompanying realization of the fact that there is yet, by rea- 

 son of the situation of the member, immobilized as it is by its struc- 

 ture and its surroundings, room left for a not unfavorable prognosis. 

 Only a slight manipulation will be needed in the treatment of this 

 lesion. To render the immobility of the region more fixed, to support 

 the bones in their position by bandaging, and to establish forced 

 immobility of the entire body with the slings is usually all that is re- 

 quired. Ringbone, being a common sequela of the reparative process, 

 must receive due attention subsequently. One of the severest com- 

 plications likely to be encountered is an immobile joint (anchylosis). 

 Neurectomy of the median nerve may relieve lameness after a frac- 

 ture of the phalanges. 



FBACTUBES OF THE THIRD PHALANX (OS PEDIS). 



These lesions may result from a penetrating street nail, or follow 

 plantar or median neurectomy. In the latter instance it is caused by 

 the animal setting the foot down carelessly and too violently, and 

 partly due to degeneration of bone tissue which follows nerving. 



Though these fractures are not of very rare occurrence, their recog- 

 nition is not easy, and there is more of speculation than of certainty 

 pertaining to their diagnosis. The animal is very lame and spares 

 the injured foot as much as possible, sometimes resting it upon the 

 toe alone and sometimes holding it suspended in the air. The foot 

 is very tender, and the exploring pinchers of the examining surgeon 

 causes much pain. During the first twenty-four hours there is no 

 increased pulsation in the digital and plantar arteries, but on the 

 second day this symptom is apparent. 



There is nothing to encourage a favorable prognosis, and a not 

 unusual termination is an anchylosis with either the navicular bone 

 or the coronet. 



No method of treatment needs to be suggested here, the hoof per- 

 forming the office of retention unaided. Local treatment by baths 

 and fomentations will do the rest. It may be months before there is 

 any mitigation of the lameness. 



An ultimate recovery depends to a great extent upon whether the 

 other foot can support the weight during the healing process without 

 causing a drop sole in the supporting foot. 



