564 
WOUNDS AND BRUISES OF THE METACARPUS. 
for long periods. This is particularly true of extravasations over the 
head of the internal small metacarpal bone, where the subcutaneous 
bursa is often involved. 
Treatment. Recent wounds require the strictest antisepsis. In 
many cases, unfortunately, they are already infected by the bandages 
applied to check bleeding, but can generally be efficiently disinfected, 
even twelve to twenty-four hours after injury. Bleeding must be 
checked by ligaturing vessels with sterilised material. The limb must 
then be carefully washed with soap and water, the wound and its 
surroundings rinsed with sublimate or carbolic solution, all foreign bodies 
removed, and the wound washed out with a powerful stream of antiseptic 
fluid. If asepsis seems possible, the wound, and even the ends of the 
tendon, should be sutured, and a dressing moistened with antiseptics 
applied, and repeatedly wetted during the first day or two with sublimate 
solution. Provided it is not sodden with blood or wound discharge, the 
dressing is left in position until the animal begins to place weight on the 
limb, or the wound is healed, otherwise it must be renewed, under 
antiseptic precautions. 
Failing asepsis, the separation of necrotic portions of tendon must be 
assisted, and excessive proliferation of tissue around the wound checked. 
Portions already partially separated can be removed with the scissors 
and knife. Over-prominent growths may be checked by astringents, 
such as glutol, tannoform, amyloform, tannin mixed with equal quantities 
of iodoform, or by alum or sulphate of zinc in powder ; a well-fitting 
pressure dressing serves the same purpose. Sometimes new growths 
may require to he removed with the knife or curette. All such surgical 
wounds must be kept very clean to prevent infection. During recovery 
the patient should be rested. 
Where tendon sheaths are also injured, extreme attention must be given 
to antiseptic precautions. Reported cases show that careful antisepsis 
may secure healing even in severe injuries of tendons and tendon sheaths. 
Bruising of the metacarpus, due to kicks, &c., often causes formation 
of haemorrhagic or lymph extravasations of the size of a walnut, or hen’s 
egg. If soon opened troublesome bleeding may result; on the other 
hand, absorption takes a long time, particularly in injuries about the 
head of the inner small metacarpal, accompanied by extravasation into 
the subcutaneous tissue lying here. Lameness is rare, and animals can 
be worked, whilst reduction of swelling is encouraged by continuous 
compression and daily massage. If, in valuable horses, operation be 
attempted, strict antisepsis must be observed, for pus formation may be 
followed by subfascial cellulitis and troublesome consequences. Extrava¬ 
sations of lymph sometimes lead to sinus formation, and therefore should 
not be incised too early. 
