Lameness of the Horse / Veterinary Practitioners' Series, No. 1

by John Victor Lacroix

Many cases are treated successfully in draft types of animals (where the subjects are not kept at work that occasions serious irritation to the affected parts) by blistering the exostosis repeatedly and allowing the animals to continue in service. In such cases, it is unreasonable to expect to check the size of the exostosis and, of course, such methods are not employed where lameness causes distress to the subject.

Firing usually causes prompt recovery from lameness and is a dependable manner of treating such cases but there remains more blemish following cauterization than where vesication is done.

OPEN FETLOCK JOINT.

This condition, because of the frequency with which it occurs may be taken as typal, from the standpoint of treatment and results obtained therefrom. While it serves to constitute a basis from which other joints, when open, are to be considered, due allowance must be made for the fact that, as has been previously mentioned, some articulations when open constitute cause for grave consequences; while with others an open capsule, even when infected, does not cause disturbance enough to be classed as difficult to handle. Moreover, the fetlock joint is admirably suited, anatomically, to bandaging; and when wounded, is easily kept protected by means of surgical dressings. This fact is of great importance in influencing the course and termination in any given case of open fetlock joint and should not be forgotten.

There is no logical reason for comparing the pedal joint with the pastern on the basis that it may also be completely and securely bandaged. Open navicular joint does not occur, as a rule, except by way of the solar surface of the foot, and the introduction of active and virulent contagium is certain to happen; consequently, an acute synovitis quickly resulting in an intensely septic and progressively destructive arthritis soon follows in perforation of the capsule of the distal interphalangeal articulation.

Etiology and Occurrence.—Wounds of the fetlock region resulting in perforation or destruction of a part of the capsular ligament are caused by all sorts of accidents, such as wire cuts, incised wounds occasioned by plowshares, disc harrows, stalk cutters and other farming implements. In runaways the joint capsule is sometimes punctured by sharp pieces of wood or other objects. In horses driven on unpaved country roads the fetlock is occasionally wounded by being struck against the sharp end of some object, the other end of which is firmly embedded in the ground. In one instance the author treated a case wherein the fetlock joint was perforated by the sickle-guard of a self-binder. In this case there occurred complete perforation causing two openings through the cul-de-sac of the joint. Such wounds are produced by implements which are, to say the least, non-sterile, and this perforation of the uncleansed skin conveys infectious material into the joint capsule. Yet in many instances, especially in country practice, no infectious arthritis results where cases are promptly cared for.

Symptomatology.—A difference in the character of symptoms is evidenced when dissimilar causes exist. Small penetrant wounds which infect the synovial membranes cause infectious arthritis in some cases, whereas a wound of sufficient size to produce evacuation of all synovia will, in many instances, cause no serious distress to the subject, even when not treated for several days. If it is not evident that an open joint exists and the articular cavity is not exposed to view a positive diagnosis may be early established by carefully probing the wound. In some cases where a small wound has perforated the joint capsule, swelling and slight change of relation of the overlying tissues may preclude all successful exploratory probing. In such instances it is necessary to await development of symptoms. Twenty-four hours after injury has been inflicted, there is noticeable discharge of synovia which coagulates about the margin of the orifice, where synovial discharge is possible. Particularly evident is this accumulation of coagulated synovia where wounds have been bandaged—there is no mistaking the characteristic straw-colored coagulum which, in such cases, is somewhat tenacious.

No difference exists between other symptoms in infectious arthritis caused by punctures, and non-infectious arthritis, excepting the intensity of the pain occasioned, the rise in temperature, circulatory disturbances, etc.; all of which have been previously mentioned.

Treatment.—Just as has been stated in discussions on the subject of open joint, probing or other instrumentation is to be avoided until the exterior of the wound and a liberal area surrounding has been thoroughly cleansed—too much importance can not be placed on this preliminary measure. In cases of open joint where ragged wound margins exist and the interior of the joint capsule is contaminated, much time is required to thoroughly cleanse all soiled parts. In some instances an hour's time is required for this cleansing process after the subject has been restrained and prepared. In order to thoroughly cleanse these delicate structures without doing them serious injury, one ought to be skillful and careful in all manipulations of the exposed parts of the joint capsule.