BROKEN KNEES 511 



accident depends upon the character of the road-bed and the 

 distance slid after the knees have struck it. Macadam and 

 gravel roads produce the most formidable varieties. In re- 

 gard to extent, the injury varies from a trivial abrasion to an 

 extensive excavation of the whole anterior part of the knee, 

 including the tendon sheaths and the tendons, even expos- 

 ing the carpal bones. And in addition, road dirt, sand and 

 gravel are ground into the mutilated tissues and defy re- 

 moval except by dissection. .The accident is usually a 

 grave one. Some may even prove fatal; others heal with a 

 rigid scar that limits flexion, and nearly all of them leave 

 an indelible, conspicuous, denuded blemish, thereafter in- 

 terpreted as an evidence that the horse is an habitual stum- 

 bler. 



TREATMENT.— The wound must be disinfected with 

 more than ordinary care. The leg is showered with water 

 to rinse off all the sand and dirt, the hair is shaved from the 

 immediate surroundings, the dirt-containing tissues carefully 

 dissected away, and finally the wound is irrigated with mer- 

 curic chloride i-iooo for no less than one-half to one hour. 

 The wound having thus been disinfected and all of the bleed- 

 ing arrested, a brace (Fig. 258) is placed upon the leg to pre- 

 vent flexion and a dressing composed of boric acid 75% and 

 iodoform 25% is bound to the wound with cotton and band- 

 age. The antiseptic powder is used in abundance and re- 

 newed twice daily during the first eight to ten days. When 

 the synovial discharge is copious it may be changed three 

 times daily. After the granulations have filled the cavity 

 and the discharge has ceased, astringents are applied until 

 sclerogensis is complete. The brace is dispensed with as 

 soon as the formative tissue is substantial enough to pre- 

 vent Assuring from flexion. If kept on too long a stiff knee 

 may result, in the more serious cases. A little exercise when 

 the healing has progressed to a safe point is advisable, but 

 the standing position must be maintained until the scar has 

 become a quite substantial affair. 



Cherry's operation, which consists of excising an island 

 of skin shaped like a melon slice, with the abrasion within, 

 and then bringing the edges together with sutures assisted 

 by two lateral relaxing incisions, is a special method of 

 handling broken knees. But in spite of the fact that it has 

 been recommended as a classical procedure to no less than 

 two generations of veterinarians, it has never gained popu- 

 larity, because it is only applicable to the circumscribed abra- 

 sion that will heal with even less blemish than that produced 

 by the lateral relaxing incisions. 



