DISEASES. 731 



Toward the end of the operation, the surgeon -will, with the 

 finger, carefully explore the condition of the parts, to insure him- 

 self that the cartilage is entirely removed ; that the articular syn- 

 ovial sac has been preserved intact; that the Ugament of the joint 

 remains perfect, and that the parts are well washed, and ready for 

 the dressings. Although in the absence of possible complications, 

 the operation is now finished, it may yet be followed by some 

 serious sequelae, which we will next consider. 



The operation may become complicated by a variety of atten- 

 dant and accessory circumstances. Among these are, the opening 

 of the articular capsules; the wounding of the anterior lateral 

 hgament of the articulation; the ossification of the fibro-cartilage ; 

 caries of the os pedis ; and the alteration of the coronary band 

 and of the reticular tissue. 



The opening of the articular capsule, either during the oper- 

 ation, or by ulcerative process, is not so serious an accident as it 

 was originally thought to be. Still, however, it requires some at- 

 tention. It only becomes dangerous when the ulceration is ac- 

 companied by serious disorganization, and especially when it is 

 associated with purulent arthritis. (Renault, Hurtrel, D'Arboval, 

 Bernard). It is treated by simple pressure, camphorated paste, a 

 httle corrosive sublimate mixed with starch, or better, with 

 Egyptiacum ointment. 



The wound of the ligaments has also been considered a very 

 serious accident, which, according to Girard, cripples an animal 

 permanently. But Lafosse thinks this an exaggerated notion, and 

 claims to have witnessed the radical recovery of animals after the 

 necrosis and sloughing of the ligament. 



If ossification of the cartilage is discovered during the opera- 

 tion, the removal of all the unossified portion is first proceeded 

 with, in order to prevent a recurrence of the disease. The extir- 

 pation of the osteo-cartilaginous portion is then effected, either 

 with a small drawing-knife, or the gouge, or the bone forceps. 

 The removal is made as far as the ossification is found to be com- 

 plete, the operator making sure that every portion of cartilage is 

 thoroughly destroyed. If the ossification is but partial or irregu- 

 lar, the surgeon must be guided by the condition of the parts. 

 "When the entire cartilage has undergone ossification, its suscepti- 

 bility to caries has ceased. 



"When caries of the os pedis exists, the part must be destroyed 



