242 DISEASES OF BONE. 



cutting out splints are operations which should be undertaken only 

 by persons who are well acquainted with the anatomy of the 

 part. 



If we are treating horses which have to " pay their way " at all 

 hazards, or if the nature of the splint does not admit of mild 

 measures, it will generally be best, in the first instance, to try 

 periosteotomy or surgical removal of the splint. 



Periosteotomy, which consists in cutting down on the splint and 

 thus dividing the periosteum (covering membrane of the bone), 

 gives, as a rule, great relief to the lameness caused by the painful 

 pressure of the bony enlargement (the splint) on the highly sensi- 

 tive periosteum, which is hard, inelastic, and plentifully supplied 

 with nerves. Also, by cutting deeply into the enlargement, we 

 relieve the inflammation by the bleeding from the congested 

 blood vessels within the bone, as well as by division of the over- 

 stretched covering membrane. 



Periosteotomy is best performed on the horse when he has been 

 cast (p. 641) and properly secured. In order to diminish the 

 sensibility of the part, we might make four or five subcutaneous 

 injections (p. 633), near the intended incisions, of about 10 drops 

 each of a 5 per cent, solution of hydrochlorate of cocaine ; or we 

 may put the animal under the influence of chloroform (p. 605). 

 Having disinfected the instruments (p. 70) and shaved off the 

 hair of the part to be operated on, we apply an Esmarch bandage 

 from the hoof to above the knee, where we put on a tourni- 

 quet; and cut deeply into the enlargement, through the skin 

 and periosteum. Before Lister demonstrated the immense ad- 

 vantage to be obtained from treating surgical wounds antisep- 

 tically, such an incision would have taken a long time to heal, 

 and would have left a very ugly scar ; but under the new mode 

 of treatment, the separated edges quickly unite, and the resulting 

 blemish is trifling. 



Surgical removal of a splint can be performed by casting the 

 horse, injecting cocaine (p. 608) or giving chloroform (p. 605), 

 applying an Esmarch bandage and tourniquet, disinfecting the 

 part, and making a longitudinal incision through the skin in such 

 a manner as to expose the enlargement, which can be removed 

 by a gouge or bone forceps, while the cut edges are held back on 

 each side. The part is treated antiseptically (p. 70), sutured 

 (p. 73), dressed with tannoform or some other suitable anti- 

 septic (p. 67), covered with a few layers of antiseptic cotton- 

 wool, and bandaged. Colonel Nunn, Deputy Director-General, 

 A.V.D., remarks in "The Veterinary Record," June 22, 1901, 

 that : " I always removed the growth with a McEwan's osteotome, 

 either gouge or chisel shaped, and a mallet. I found that it was 



