WOUNDS 215 



most wounds of the foot. When detected, it calls for 

 immediate surgical interference in the shape of removal 

 of the horn of the sole or the frog, as the case may be. 

 This we shall consider further under the treatment. 



(b) Separation of the Homy Frog. — This is a sequel to 

 pus formation in the sensitive structures immediately 

 beneath it, and the condition makes itself apparent by 

 a line of separation between the horn and the skin of the 

 heel of the injured side. 



(c) WouiuUn(i of the Plantar Aponeurosis. — This occurs 

 when a moderately-deep penetration of the horn of the 

 middle zone has taken place. It is always most painful, 

 especially when complicated by necrosis. The heel is 

 then persistently elevated, and lameness is extreme, in 

 some cases so severe as to cause the leg to be carried 

 altogether. 



In favourable cases the necrosed piece of tendon is 

 sloughed off by the process of suppuration, and escapes 

 with the discharges from the wound. There is then an 

 abatement in the symptoms, and recovery is rapid. 



Commonly, however, on account of the non-vascularity 

 of the structure of the tendon, the necrotic spot in it tends 

 to spread. The wound is thus led to become fistulous in 

 character, and the pus forming within it prevented from 

 escaping from the original opening. As a result, lameness 

 and fever persist. There is a gradual increase in the 

 severity of the symptoms, and later fistulous openings 

 appear in the hollow of the heel. 



(d) Puncture of the Navicular Bursa. — This results from a 

 prick in exactly the same position as that last described, 

 and means that the penetrating object has gone deeper. 

 It may be distinguished from puncture of the plantar 

 aponeurosis alone by the fact that there is an excessive 

 discharge of synovia from the wound. This, as it escapes, 

 is at first clear and straw-coloured. Later it becomes 

 cloudy and flaked with pus, and shows a tendency to 

 coagulate in yellowish clots. 



Pain and accompanying fever is most marked, much 



