38 DISEASES OF THE FOOT. 



Diagnosis. The diagnosis is easy, inasmuch as the lameness almost 

 directs examination to the foot. 



Prognosis is rarely grave. The direction, the situation and mode of 

 insertion of the flexor tendon, which forms the plantar aponeurosis, 

 ensure this aponeurosis being rarely injured by objects penetrating from 

 without. The points of the offending bodies usually pass either forwards 

 to the phalanx or backwards in the direction of the plantar cushion. 



Treatment. The first stage in treatment consists in removing the 

 foreign body and thoroughly thinning the neighbouring horn. An 

 antiseptic poultice consisting of linseed meal saturated with 3 per cent, 

 carbolic acid or creolin solution is then applied. Considerable and pro- 

 gressive improvement usually takes place in a few hours. If lameness 

 persists, surgical interference becomes necessary; in the anterior zone 

 it is confined to removing any dead portions of the velvety tissue and to 

 extirpating the fragment of bone which has undergone necrosis. In the 

 posterior zone the sinus must be probed and laid open, so that all the 

 diseased parts can be treated as an open wound. 



If, as happens in exceptional cases, the plantar aponeurosis is found 

 to be severely injured, the complete operation for picked-up nail, as 

 practised in the horse, may be performed, or the claw may be ampu- 

 tated. In the former operation the horn covering the sole is first 

 thinned " to the blood." 



The stages of operation are as follows : — 



(1.) Ablation of the anterior portion of the plantar cushion. Trans- 

 verse vertical incision at a distance of IJ inches in front of the heel ; 

 excision of the anterior flap. 



(2.) Transverse incision and ablation of the plantar aponeurosis by 

 the same method. 



(3.) Curettage of the point of implantation of the aponeurosis into 

 the bone. 



(4.) Antiseptic dressing of the claw. 

 Finally, if the primary lesion, wherever it may have started, has 

 become complicated by arthritis of the interphalangeal joint, it wifl 

 be necessary to remove the claw, or, better still, to remove the two 

 last phalanges, the latter operation being easier than the former, and , 

 providing flaps of more regular shape and better adapted for the 

 production of a satisfactory stump. 



INFLAMMATION OF THE INTERDIGITAL SPACE. 

 (CONDYLOMATA.) 



Condylomata result from chronic inflammation of the skin covering 

 the interdigital ligament. Any injury to this region causing even 

 superficial damage may result in chronic inflammation of the skin 



