The affected animals require a month to three months' time for recovery to take place in the average favorable cases of ringbone.
Median neurectomy is of service in many instances where lameness is not completely relieved by the use of the actual cautery and no bad results attend the performance of this operation even though no benefit is derived thereby. Plantar neurectomy is contraindicated in all cases where there exists much lameness. If lameness is due to acute inflammation bad results such as sloughing and loss of the hoof may follow; and if large exostoses mechanically interfere with function of the joint, or where articular erosions exist, no possible good can come from neurectomy. Careful discrimination should be employed in selecting cases for neurectomy for this operation; otherwise, it is very likely to prove disappointing.
Open Sheath of the Flexors of the Phalanges.
This condition does not differ from a like affection involving other tendons except that the function of these tendons is such that large synovial sheaths are necessary, and when synovitis exists, the condition then becomes more serious.
Infectious synovitis involving these tendons in the fetlock region is of more frequent occurrence than a like affection of carpal or tarsal sheaths. With the exception of the extent of the involvement and distress occasioned thereby, synovitis the result of open tendon sheaths, is similar wherever it occurs.
Etiology.—The same conditions which are responsible for open fetlock joint and other wounds of the pastern region, cause open tendon sheaths of the flexor tendons.
Symptomatology.—Because of the size and extent of this sheath and the different manner in which it is opened, there is manifested dissimilar symptoms in different cases. A nail puncture which perforates the sheath in the pastern region and at the same time produces an infectious synovitis, will cause a markedly different manifestation than will a wound which freely opens the sheath above the fetlock. In the first instance, the condition is much more painful; swelling is intense in some cases; and if the subject does not possess sufficient resistance so that spontaneous resolution promptly occurs, surgical evacuation of pus is usually necessary. When these tendon sheaths are opened, there follows a reaction which is quite analogous to that which exists in arthritic synovitis, but instead of ankylosis, adhesions with thecal obliteration occur. Rarely there result cartilaginous and osseous formations.
The constitutional disturbances which characterize this condition vary with the degree of distress occasioned. As the infection is virulent and causes serious destruction of the affected parts, so does evidence of malaise and finally distress appear. Detailed discussions of symptomatology in similar conditions have heretofore been given, and further repetition is unnecessary.
Treatment.—The same general plan of treatment which is employed for handling open joint is put in practice in these cases. Following the preoperative cleansing of the external wound and adjacent surfaces, where liberal drainage exists, tincture of iodin is injected into the sheath, the parts covered with a suitable dressing powder, and the entire member is carefully dressed with cotton and bandages.
Subsequent treatment is the same as has been outlined in the discussion of open fetlock joint on page [112]. The same general plan of after-care is necessary. Recovery, however, does not require so much time ordinarily, yet punctures of the sheath occasioned by nails or other small implements make for long drawn out cases of infective synovitis.