SPRAINS OF TENDONS.—NERF-FERURE.—TENOSITIS. 309 
the glenoid cartilage, the reénforcing aponeurosis of the perforans 
(fig. 72). 
Which of these lesions is most frequent ? We have just seen the pro- 
portion mentioned by Prudhomme. According to Siedamgrotzky, the 
lesions of the carpal band are far the mostcommon. Out of eleven cases, 
Barrier has found five on the suspensory ligament. According to Jacoulet 
and Poy, this ligament would be diseased in 50 per cent. of the cases, 
while the carpal band would be only in 12 per cent. (Poy). The great 
difference between these figures is due to numerous conditions, specially 
to the difference of conformation and work of the animals under the ob- 
servation of those authors. The professor from Dresden insisted on that 
point. He has shown that the lesions of the suspensor and of the inferior 
sesamoid were met specially in saddle, hunting or steeple-chase horses and 
in fast trotters. Long and weak pasterns, high heels, high heeled shoes, 
high action, fast gait with heavy load, misteps, jumps—all of those favor 
their development. Alterations of the perforans, of the carpal band, of 
the ligaments and bands of the fetlock and coronet are more particularly 
seen in heavy draught horses, exposed to violent and sudden hyperexten- 
sions. Low heels, feet improperly pared, work on uneven ground, and 
heavy loads predispose to them. This we observed in our clinics at 
Alfort among the draught horses which form the best part of our patients ; 
as in the days of Prudhomme, lesions of the carpal band are those that we 
have most commonly to treat. But if the carpal band and the reénforcing 
aponeurosis are more commonly affected than the deep flexor, the lacera- 
tions of this tendon are not rare. According to Siedamgrotzky, they most 
commonly occur between the sesamoid pulley and the glenoid cartilage ; 
they are due to the chronic inflammation of the sesamoid, carpal or tarsal 
sheath. Barrier, on the contrary, sees specially in those alterations of the 
deep flexor, atrophic and degenerating lesions, due to chronic synovitis. 
The frequency of the primitive lesion of the perforans is not doubtful ; 
however, in many instances, those lesions of the perforans seem to be 
brought on by primary synovitis, which prevents the action of the sesamoid 
pulley. 
Let us add, however, that all phlegmasies of the flexor tendons do not 
follow efforts or traumatisms. No more than others, tendinous tissue is 
not exempt from inflammatory process of infectious origin (pneumonia, 
influenza, rheumatism). 
The symptoms of “ nerf-férure” are generally well marked. At times 
the swelling is large, diffuse, involving the whole leg; at others it is 
limited to a portion of the tendon or of the carpal band ; there are cases 
where in one day it assumes large dimensions (hemorrhage or extensive 
