The shoe once off, the holes made by the nails in the horn should be minutely examined for the presence of hæmorrhage, inflammatory fluid, or pus exuding from them, and also for evidence of their correct placing in the foot. Should fluid matter issue from any one of them, or should it be deemed that one has approached too near the inner margin of the white line, more especially if tenderness exists around it, that hole should be followed up with a 'searcher' or small drawing-knife until diagnosis is certain.
Complications.—Before proceeding to discuss the complications that may arise in the case of pricked foot, we may call to mind that the anatomy of the parts teaches us that the most serious position in which a punctured wound can occur is at the centre of the foot. Here the plantar aponeurosis, the navicular bursa, the navicular bone itself, or the pedal articulation may be injured.
Anterior to this position the most serious mischief that can ordinarily result is stabbing of the os pedis.
Posterior to the position we have named, the only structure to be injured is the plantar cushion.
Anatomically, then, the inferior surface of the foot may be divided into three zones, as follows:
A. Anterior, extending from the toe to the point of the frog.
B. Middle, extending from the point of the frog to the commencement of its median lacuna.
C. Posterior, including everything posterior to the middle zone. This division of the inferior surface of the foot into zones will be somewhat of a guide also when describing the complications next to follow:
(a) Suppuration.—This is the common complication of most wounds of the foot. When detected, it calls for immediate surgical interference in the shape of removal of the horn of the sole or the frog, as the case may be. This we shall consider further under the treatment.
(b) Separation of the Horny Frog.—This is a sequel to pus formation in the sensitive structures immediately beneath it, and the condition makes itself apparent by a line of separation between the horn and the skin of the heel of the injured side.