PUNCTURED WOUNDS OF FOOT. 401 



lameness develops until suppnration is established. In all cases of 

 foot lameness, especially if the cause is obscure, the foot should be 

 examined for evidence of injury. 



The lameness from punctured wounds, accompanied by suppura- 

 tion, is generally severe, the patient often refusing to use the aft'ected 

 member at all. The pain being lancinating in character, he stands 

 with the injured foot at rest or constantly moves it back and forth. 

 In other cases the patient lies down most of the time with the feet 

 outstretched ; the breathing is rapid, the pulse fast, the temperature 

 elevated, and the body covered with patches of sweat. 



When the plantar aponeurosis is injured, the pus escapes with diffi- 

 culty and the wound shows no signs of healing; the whole foot is hot 

 and very painful. If the puncture involves the sesamoid sheath, the 

 synovial fluid escapes. At first this fluid is pure, like joint Avater, but 

 later becomes mixed with the products of suppuration and loses its 

 clear amber color. Suppuration generally extends up the course of 

 the flexor tendon, an abscess forms in the hollow of the heel, and 

 finally opens somewhere below the fetlock joint. The whole coronet 

 is more or less swollen, the discharge is profuse and often mixed with 

 blood, yet the suffering is greatly relieved from the moment the 

 abscess opens. 



If the puncture reaches the navicular bone the lameness is intense 

 from the beginning; but the only certain v:?.y to determine the exist- 

 ence of this complication is by the use of the probe, and unless there 

 is a free escape of synovia it must be used Avitli the greatest of care, 

 else the coffin joint may be opened. 



If the coffin joint has been penetrated, either by the offending in- 

 strument or by the process of suppuration, acute inflammation of the 

 joint follows, accomi^anied by high fever, loss of appetite, etc. The 

 ankle and coronet are now greatly swollen, and dropsy of the leg to 

 the knee or hock, or even to the body, often follows. If the j^rocess 

 of suppuration continues, small abscesses appear at intervals on dif- 

 ferent parts of the coronet, the patient rapidly loses flesh, and may 

 die from intense suffering and blood poisoning. In other cases the 

 suppuration, soon disappears, and recovery is effected by the joint 

 becoming stiff (anchylosis). 



When the wound is forward, near the toe, and deep enough to injure 

 the coffin bone, caries always results. The j)resence of the dead pieces 

 of bone can be determined by the use of the i)robe; the bone feels 

 rough and gritty. Furthermore, there is no disposition upon the part 

 of the wound to heal. 



Besides the complications above mentioned, others ex|ually as seri- 

 ous may be met with. The tendons may soften and ru]:)ture, the hoof 

 may slough off, quittors develop, or sidebones and ringbones grow. 



II. Dnr. 7!tr>. ^0-2 2(> 



