502 VETERINARY SURGICAL THERAPEUTICS. 
the external ligament, sprains on the bones, which result ultimately itr 
periostosis of the fetlock, localized first on the outside, but gradually 
spreading to the anterior region. The animal does not stand plumb. 
any more, and the resting is made most exclusively on the outside of 
the external nail. 
Such serious lesions are incurable, and render the animal unfit for any 
work, but when treated early, they may be avoided. Festal says: The: 
internal nail must be pared, a thick shoe should be placed on the outside- 
toe, and at the same time friction, somewhat irritating, made over the: 
coronary band to stimulate the growth of the hoof. Blisters and firing: 
have been used against the periostitis, almost always without success. 
VIl.—Phatlangeal Sprains. 
According to Percivall, these lesions are much more frequent than 
those of the fetlock. 61 cases counted by him show five of the 
metacarpo-phalangeal joint, 40 of the first phalangeal articulation, 16 of 
the foot. Some ten years ago, Vatel insisted on the frequency of the. 
sprain of the first phalangeal joint. 
Many of these digital sprains give rise to symptoms which are not much. 
marked ; at times there is local hyperthermia, and motion is painful. 
Manipulations of the blacksmith in removing the shoe increase the lame- 
ness; this is an important fact, says Vatel. 
Once the diagnosis is made, the first indication of treatment is rest, 
the animal loose in the field or a box stall. At the onset, cold baths or 
continued irrigations of the foot are to be recommended. Later, damp: 
and warm compresses, blisterings. Immobilization with plastered or 
Delorme bandages gives also good results. 
If lameness continues, if specially the periostitis, which has taken place: 
on the articular borders, promotes osteophytes and threatens ankylosis, 
firing must be resorted to. Too often, cauterization fails and high and. 
double neurotomy has to be performed, or again the median or the 
sciatic. With very large periostosis of the fetlock and pasterns, these 
last operations will ordinarily produce sufficient improvement to permit. 
work. 
The sprain of the re-enforcing sheath of the perforans and that of the 
posterior ligaments of the articulation of the coronet, are recognized 
from ordinary phalangeal sprains by the situation of the local phenom- 
ena (swelling and pain) to which they give rise, and which are located 
on the posterior and lateral regions of the pastern and of the coronet. 
When once diagnosed, it is recommended to shorten the toe of the foot, 
save the heels and apply a thick heeled shoe or one with high caulks. At 
