Bog Spavin : htm l Distension_of_the_Tarsal_Joint_Capsule_Bog_Spavin Distension of the Tarsal Joint Capsule Bog….

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Silver plated necklace with horse shoe Horses-store.comBog Spavin : htm l Distension_of_the_Tarsal_Joint_Capsule_Bog_Spavin Distension of the Tarsal Joint Capsule Bog….

HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Chronic_Gonitis” Chronic Gonitis HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Open_Stifle_Joint” Open Stifle Joint HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Fracture_of_the_Tibia” Fracture of the Tibia HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Rupture_and_Wounds_of_the_Tendo_Achillis” Rupture and Wounds of the Tendo Achillis HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Spring-Halt_String-Halt” Spring-Halt (String-Halt) HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Open_Tarsal_Joint” Open Tarsal Joint HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Fracture_of_the_Fibular_Tarsal_Bone_Calcaneum” Fracture of the Fibular Tarsal Bone (Calcaneum) HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Tarsal_Sprains” Tarsal Sprains HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Curb” Curb HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Spavin_Bone_Spavin” Spavin (Bone Spavin) HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Distension_of_the_Tarsal_Joint_Capsule_Bog_Spavin” Distension of the Tarsal Joint Capsule (Bog Spavin) HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Distension_of_the_Tarsal_Sheath_of_the_Deep_Digital_Flexor” Distension of the Tarsal Sheath of the Deep Digital Flexor (Thoroughpin) HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Capped_Hock” Capped Hock HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Rupture_and_Division_of_the_Long_Digital_Extensor” Rupture and Division of the Long Digital Extensor (Extensor Pedis) HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Wounds_From_Interfering” Wounds from Interfering HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Lymphangitis” Lymphangitis HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “AUTHORITIES_CITED” Authorities Cited HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “INDEX” Index ILLUSTRATIONS Fig.   1— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image01” Hoof Testers Fig.   2— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image02” Muscles of Left Thoracic Limb, Lateral View Fig.   3— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image03” Muscles of Left Thoracic Limb, Medial View Fig.   4— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image04” Sagital Section of Digit and Distal Part of Metacarpus Fig.   5— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image05” Ordinary Type of Heavy Sling — Fig. 46— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image46” Oblique Fracture of the Femur Fig. 47— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image47” Fracture of Femur After Six Months’ Treatment Fig. 48— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image48” Aorta and Its Branches Showing Location of Thrombi Fig. 49— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image49” Thrombosis of the Aorta, Iliacs and Branches Fig. 50— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image50” Chronic Gonitis Fig. 51— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image51” Position Assumed in Gonitis Fig. 52— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image52” Spring-halt Fig. 53— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image53” Lateral View of Tarsus Showing Effects of Tarsitis Fig. 54— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image54” Right Hock Joint Fig. 55— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image55” Spavin Fig. 56— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image56” Bog Spavin Fig. 57— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image57” Thoroughpin Fig. 58— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image58” Fibrosity of Tarsus in Chronic Thoroughpin Fig. 59— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image59” Another View of Case Shown in Fig. 58 Fig. 60— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image60” “Capped Hock” Fig. 61— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image61” Chronic Lymphangitis Fig. 62— HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image62” Elephantiasis INTRODUCTION Lameness is a symptom of an ailment or affection and is not to be considered in itself as an anomalous condition.

It is the manifestation of a structural or functional disorder of some part of the locomotory apparatus, characterized by a limping or halting gait.

Therefore, any affection causing a sensation and sign of pain which is increased by the bearing of weight upon the affected member, or by the moving of such a distressed part, results in an irregularity in locomotion, which is known as lameness or claudication.

A halting gait may also be produced by the abnormal development of a member, or by the shortening of the leg occasioned by the loss of a shoe. For descriptive purposes lameness may be classified as true and false.

True lameness is such as is occasioned by structural or functional defects of some part of the apparatus of locomotion, such as would be caused by spavin, ring-bone, or tendinitis.

False lameness is an impediment in the gait not caused by structural or functional disturbances, but is brought on by conditions such as may result from the too rapid driving of an unbridle-wise colt over an irregular road surface, or by urging a horse to trot at a pace exceeding the normal gait of the animal’s capacity, causing it to “crow-hop” or to lose balance in the stride.

The latter manifestation might, to the inexperienced eye, simulate true lameness of the hind legs, but in reality, is merely the result of the animal having been forced to assume an abnormal pace and a lack of balance in locomotion is the consequence. The degree of lameness, though variable in different instances, is in most cases proportionate to the causative factor, and this fact serves as a helpful indicator in the matter of establishing a diagnosis and giving the prognosis, especially in cases of somewhat unusual character.

An animal may be slightly lame and the exhibition of lameness be such as to render the cause bafflingly obscure.

Cases of this nature are sometimes quite difficult to classify and in occasional instances a positive diagnosis is impossible.

Subjects of this kind may not be sufficiently inconvenienced to warrant their being taken out of service, yet a lame horse, no matter how slightly affected, should not be continued in service unless it can be positively established that the degree of discomfort occasioned by the claudication is small and the work to be done by the animal, of the sort that will not aggravate the condition. Subjects that are very lame—so lame that little weight is borne by the affected member—are, of course, unfit for service and as a rule are not difficult of diagnosis.

For instance, a fracture of the second phalanx would cause much more lameness than an injury to the lateral ligament of the coronary joint wherein there had occurred only a slight sprain, and though crepitation is not recognized, the diagnostician is not justified in excluding the possibility of fracture, if the lameness seems disproportionate to the apparent first cause. The course taken by cases of lameness is as variable as the degree of its manifestation, and no one can definitely predict the duration of any given cause of claudication. Because of the fact that horses are not often good self-nurses at best, and that it is difficult to enforce proper care for the parts affected, one can not wisely state that resolution will promptly follow in an acute involvement, nor can he predict that the case will or will not become chronic.

Experience has proved that complete or partial recovery may result, or again, that no change may occur in any given case, and that in some instances even where rational treatment is early administered, a decided aggravation of the condition may follow unaccountably. However, because of the economic element to be reckoned with, it is of some value to be able to give a fairly accurate prognosis in the handling of cases of lameness, as in the majority of instances the treatment and manner of after-care are determined largely by the expense that any prescribed line of attention will occasion. — Prognosis.—An animal having hereditary predisposition to spavin is not likely to recover completely whether this predisposition be due to faulty conformation or susceptibility to bone changes.

In predicting the outcome, the temperament of the subject is to be taken into account, as well as the character of service the animal is expected to perform.

And finally, a very important feature to be noted, is the location of the exostosis.

If situated rather high and extending anterior to the hock, there is less likelihood of recovery resulting than where an exostosis is confined to the lower row of tarsal bones.

When situated anterior to the tarsus a large exostosis may by mechanical interference to function, cause lameness when all other causes are absent.

In making examinations one must not be deceived by the inconspicuous and seemingly insignificant exostosis which has a broad base.

In some cases of this kind, dealers style the condition as “rough in the hock” when as a matter of fact, in some instances, incurable spavin lameness develops. Treatment.—Many incipient cases of spavin yield to vesication and a protracted period of rest.

Results depend primarily upon the nature of the affection.

However, in every instance if there is involvement of the tibial tarsal (astragalus) bone, complete recovery is highly improbable.

When the disease is confined to the lower tarsal bones, lameness subsides as soon as the degenerative changes are checked and ankylosis occurs. The use of the actual cautery when properly employed constitutes an excellent method of treatment.

The “auto-cautery” when equipped with a point of about one-eighth of an inch in diameter and about three-fourths of an inch in length is well suited for this particular operation.

Before deciding to cauterize, it is necessary to ascertain the extent of area affected.

The nearness of the exostosis to the tibiotarsal articulation can be definitely determined by palpation.

The hair over the entire surgical field is clipped and the cautery at white heat is pushed through the overlying soft tissues and into the central part of the exostosis.

Care is taken to keep the cautery-point away from the articular margin of the tibial tarsal bone about three-fourths of an inch.

No danger will result from cauterizing to a depth of three-fourths of an inch in the average case.

Two or three (and not more) centrally located points for penetration with the cautery are sufficient.

Experience has shown that several (five or six or more) punctures are not productive of good results.

When considerable cicatricial tissue is present, due to the action of depilating vesicants or other chemicals, sloughing of tissue is very apt to follow deep cauterization, if one is not careful to keep the punctures at least one-half inch apart when three are made.

It is best, in such cases, to make but two deep penetrations with the cautery but additional superficial punctures may be made if kept about three-fourths of an inch distant and not nearer than this to one another.

Sloughing of tissue is not necessarily productive of bad results but there is occasioned an open wound which usually becomes infected and necrosis of tissue may extend into the articulation.

No benefit results from sloughing and it should be avoided.

In small horses, one deep point of cauterization is sufficient if the osseous tissues are penetrated to a proper depth so that an active inflammation is induced.

The cautery may, if necessary, be reintroduced several times.

When the field of operation has been properly prepared and it is thought advisable (as where subjects are kept in the hospital for a time), the hock may be covered with cotton and bandaged and no chance for infection will occur. After cauterization the subject should be kept quiet in a comfortable stall for three weeks; thereafter, if the animal is not too playful, the run of a paddock may be allowed for about ten days and a protracted rest of a month or more at pasture is best.

It is unwise in the average case to put an animal in service earlier than two months after having been “fired.” Where cases progress favorably, lameness subsides in about three weeks after cauterization and little if any recurrence of the impediment is manifested thereafter.

However, because of violent exercise taken in some instances when subjects are put out after being confined in the stall, a return of lameness occurs and it may remain for several days or in some cases become permanent.

No good comes from the use of blistering ointments immediately after cauterization.

The actual cautery is a means of producing all necessary inflammation and it should be so employed that sufficient reactionary inflammation succeeds such firing.

The use of a vesicating ointment subsequent to cauterization invites infection because of the dust that is retained in contact with the wound.

The employment of irritating chemicals in a liquid form following firing is needless and cruel. In many instances lameness is not relieved and subjects show no improvement at the end of six weeks time and it then becomes a question of whether or not recovery is to be expected even with continued rest and treatment.

As a rule, such cases are unfavorable.

In one instance the author employed the actual cautery three times during the course of six months and lameness gradually diminished for a year.

In this case the spavin was of nearly one year’s standing when treatment was instituted.

The subject was a nervous and restless but well-formed seven-year-old gelding.

Recovery was not complete; recurrent intervals of lameness marked this case, but the horse limped so slightly that the average observer could not detect its existence after the animal had been driven a little way. Cunean tenotomy has been advocated and practiced by Abildgaard, Lafosse, Peters, Herring, Zuill and others and good results have followed in many cases so treated. Considering results, the employment of chemicals of various kinds for the purpose of relieving spavin lameness does not compare favorably with firing.

Moreover, so many animals have been tortured and needlessly blemished in the attempted cure of spavin that agents which are not of known value, the use of which are likely to result in extensive injury to the tissues, are only to be condemned. When spavin is bilateral and lameness is likewise affecting both members, prognosis is at once unfavorable.

Such cases are often benefited by cauterization but only one leg at a time should be treated. Bossi’s double tarsal neurectomy (division of the anterior and posterior tibial nerves) has undoubtedly been of decided benefit in many cases, but is not at present a popular method of treatment in this country.

This operation has its indications, however, and may be recommended in chronic lameness where no extensive exostosis exists which may mechanically interfere with function. Distension of the Tarsal Joint Capsule. (Bog Spavin.) Distension of the capsular ligament of the tibial tarsal (tibioastragular) joint with synovia is commonly known as bog spavin.

This condition is separate and distinct from that of distension of the sheath of the deep flexor tendon (perforans) though not infrequently the two affections coexist. Etiology and Occurrence.—Following strains from work in the harness or under the saddle, horses develop an acute synovitis of the hock joint, which often results in chronic synovial distension.

Debilitating diseases favor the production of this affection in some animals.

It is also frequently observed in young horses and in draught colts of twelve to eighteen months of age.

This condition occurs while the subjects are at pasture and often spontaneous recovery results by the time the animals are two years of age. HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\images\\img56-full.jpg” INCLUDEPICTURE “../AppData/Local/Temp/Horse_lameness/images/img56.jpg” \* MERGEFORMATINET Fig. 56—Bog spavin.

Showing point of view which may be most advantageously taken by the diagnostician in examining for distension of the capsular ligament of the tarsal joint. Symptomatology.—Bog spavin is recognized by the distended condition of the joint capsule which is prominent just below the internal tibial malleolus and this affection is characterized by a fluctuating swelling which varies considerably in size in different subjects.

Except in cases of acute synovitis, lameness is not present and in chronic distension of the capsule of the tarsal joint, no interference with the subject’s usefulness occurs.

In the majority of instances, the disfigurement which attends bog spavin is the principal objectionable feature.

The condition is bilateral in many instances, and in such cases the subjects have a predisposition to this condition or it follows attacks of strangles or other debilitating ailments.

Because of a rapid and unusual growth, bilateral affections are of frequent occurrence in some animals. Treatment.—The most practical method of handling bog spavin consists in aspiration of synovia and injection of tincture of iodin.

Discretion should be employed in selecting subjects for treatment, regardless of the manner in which such cases are to be handled.

Where there exists chronic distension of the joint capsule of several years’ standing in old or weak subjects, needless to say, recovery is not likely to result.

When animals are vigorous and two or three months’ time is available, treatment may be begun with reasonable hope for success. The average subject is handled standing and can be restrained with a twitch, sideline and hood.

Aspirating needles and all necessary equipment must be in readiness (sterile and wrapped in aseptic cotton or gauze) so that no delay will occur from this cause when the operation has been started.

The central or most prominent part of the distended portion of the capsule is chosen for perforation and an area of an inch and a half in diameter is shaved.

The skin is cleansed and then painted with tincture of iodin.

The sterile aspirating needle is pushed through the tissues and into the capsule with a sudden thrust.

With a large and sharp needle (fourteen gauge), synovia can be drawn from the cavity in most instances and the subject usually offers no resistance.

By compressing the distended capsule and surrounding structures with the fingers, considerable synovia may be evacuated.

In singular instances, no synovia is to be aspirated with the needle, and in such cases the amount of iodin injected needs be increased, possibly twenty-five per cent., as experience will indicate.

From two to five cubic centimeters of U.S.P.

Tincture of iodin is injected through the aspirating needle into the synovial cavity of the joint, and the exterior of the parts are vigorously massaged immediately after injection to stimulate distribution of the iodin throughout the synovial cavity.

Where a bilateral affection exists, two or three weeks’ time should intervene between the treatments of each leg.

A sterile metal syringe equipped with a slip joint for the needle is well adapted to this operation.

Lubrication of the plunger with heavy sterile vaseline or glycerin will prevent the syringe from being ruined by the iodin. Following the injection, the subject is kept in a stall or in a suitable paddock, so that conditions may be observed for four or five days.

The object sought by the introduction of iodin is not only for a local effect upon the synovial membranes in checking secretions, but the production of an active inflammation and great swelling, which will remain from four weeks to three months subsequent to the injection.

This periarticular swelling should produce and maintain a constant pressure over the entire affected parts for a sufficient length of time until normal tone is re-established. In some cases, swelling does not develop as the result of a single injection of iodin.

When marked swelling has not taken place within five days, none will occur and a repetition of the injection may be made within ten days after the first treatment has been given.

One may safely increase the amount of iodin at the second injection in such cases by one-fourth to one-third. In Europe this method of treating bog spavin has been employed by Leblanc, Abadie, Dupont and others according to Cadiot; but Bouley, Rey, Lafosse and Varrier used it with bad results.

Where a perfect technic is executed (and no other is excusable in this operation), no infection will occur if a reasonable amount of iodin is injected.

The dilution of iodin with an equal amount of alcohol has been practised by the author in many cases, but later this was found unnecessary. Other methods of treatment have been used with success.

Perhaps the most heroic consists in opening the joint capsule with a bistoury or with the actual cautery.

Such practice is too hazardous for general use and is not to be recommended, although good results should follow the employment of such methods if infectious arthritis does not occur. Line firing over the distended capsule is a practical method of treatment.

This is attended with good results in young animals in many cases, but considerable blemish is caused when sufficient irritation is produced to stimulate resolution. Vesication also is successfully employed in some instances.

However, only cases of recent origin in young animals—colts of two years or younger—yield to blistering, and in some affected colts no doubt recovery would have been spontaneous had no treatment been instituted. Ligation of the saphenous vein at two points, one above and the other below the distended ligamentous capsule, is an old operation, which has undoubtedly given good results in some cases, although it does not seem to be a rational procedure. After-Care.—After swelling has fully developed—which occurs within a week—the subject is turned to pasture and no attention is necessary thereafter.

A gradual subsidence of the swelling occurs and in the average instance, this completely resolves within six or eight weeks. Complete recovery succeeds the aspiration-and-injection-treatment in about seventy-five per cent of cases as the result of one operation, and subjects may be gradually and carefully returned to work in about sixty days after treatment has been given. Distension of the Tarsal Sheath of the Deep Digital Flexor.
(Thoroughpin.) The terms “thoroughpin” or “throughpin” are translations from the French vessignon chevillé and have the same significance.

They are so named because of the diametrically opposed distensions of the sheath of the deep flexor tendon in such manner that the distensions appear to be due to a supporting peg. Anatomy.—The theca through which the deep digital flexor (perforans) plays in the tarsal region, begins about three inches above the inner tibial malleolus and extends about one-fourth of the way down the metatarsus.

The posterior part of the capsular ligament of the hock joint is very thick in its most dependent portions and is in part cartilaginous, forming a suitable groove for the passage of the deep flexor tendon. HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\images\\img57-full.jpg” INCLUDEPICTURE “../AppData/Local/Temp/Horse_lameness/images/img57.jpg” \* MERGEFORMATINET Fig. 57—Thoroughpin.

Showing distension of the sheath of the deep flexor tendon as it protrudes antero-externally to the fibular tarsal bone (calcaneum). Etiology and Occurrence.—Strains and sequellae to debilitating diseases constitute the usual causes of this affection.

As a result of acute synovitis a chronic synovial distension of the tarsal sheath occurs.

Bog spavin is often present in case of thoroughpin but the two conditions are separate and distinct excepting in that both may occur simultaneously and as the result of the same cause.

Some animals are undoubtedly predisposed to disease of synovial structures.

The average horse that has been subjected to hard service on pavements or hard roads at fast work suffers synovial distension of bursae, thecae or of joint capsules.

Some of the well bred types such as the thoroughbred horses may be subjected to years of hard service and still remain “clean limbed” and free from all blemishes.

Thus it seems that subjects of rather faulty conformation, animals having lymphatic temperaments and the coarse-bred types, are prone to synovial disturbances such as thoroughpin, bog spavin, etc., sometimes having both legs affected. HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\images\\img58-full.jpg” INCLUDEPICTURE “../AppData/Local/Temp/Horse_lameness/images/img58.jpg” \* MERGEFORMATINET 
Fig. 58—Fibrosity of tarsus as a complication in chronic thoroughpin. Symptomatology.—Thoroughpin is characterized by a distended condition of the tarsal sheath which is manifested by protrusions anterior to the tendo Achillis.

However, where but moderate distension of the sheath exists, there is little, if any, bulging on the mesial side of the hock and but a small hemispherical enlargement is presented on the outer side of the tarsus, anterior to the summit of the os calcis.

In some instances the protruding parts assume large proportions, but always, because of the relationship between the fibular tarsal bone (calcaneum) and the tendon sheath, the larger protrusion is situated mesially. During the acute inflammatory stage there is marked lameness present but this soon subsides when local antiphlogistic agents are applied to the parts.

In fact, spontaneous relief from lameness usually results in the course of ten days’ time following the appearance of thoroughpin.

No lameness marks the advent of this affection when it develops as the result of continuous strain and concussion occasioned by hard service, and local changes tend to remain in status quo. HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\images\\img59-full.jpg” INCLUDEPICTURE “../AppData/Local/Temp/Horse_lameness/images/img59.jpg” \* MERGEFORMATINET 
Fig. 59—Another view of same case as illustrated in HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “image58” Fig. 58. Treatment.—Rest and the local application of heat or cold will suffice to promote resolution of acute inflammation and lameness when present will subside within two weeks.

In chronic affections, however, the matter and manner of effecting a correction of the condition—distended tarsal sheath—merit careful consideration.

While drainage of distended thecae and bursae by means of openings made with hot irons was practiced by the Arabs, centuries ago, and good results have attended such heroic corrective measures, nevertheless the occasional serious complications which result from infection likely to be introduced in following such procedures, cause the prudent and skilful practitioner to employ safer methods of treatment. The application of blistering agents is of no value in stimulating resorption of an excessive amount of synovia in chronic cases and the actual cautery when employed without perforation of the synovial structure, is of little benefit.

Trusses or mechanical appliances for the purpose of maintaining pressure upon the distended parts are of no practical value because of the great difficulty of keeping such contrivances in position.

They usually cause so much discomfort to the subject that they are not tolerated. A very practical and fairly successful method of treatment consists in the aspiration of a quantity of synovia and injecting tincture of iodin.

Cadiot recommends the drainage of synovia with a suitable trocar and cannula and injecting a mixture consisting of tincture of iodin, one part, to two parts of sterile water, to which is added a small quantity of potassium iodid.

The latter agent is added to prevent precipitation of the iodin.

This authority (Cadiot) further advocates the removal of practically all of the synovia that will run out through the cannula and the immediate introduction of as much as one hundred cubic centimeters of the above mentioned iodin solution.

This solution is allowed to remain in the synovial cavity a few minutes and by compressing the tissues surrounding the tendon sheath, the evacuation of as much of the contents of the synovial cavity as is practicable, is effected.

Subsequently the subject is allowed absolute rest and more or less inflammatory reaction follows.

In some cases there occur marked lameness and some febrile disturbance, but where a good technic is carried out, no bad results follow.

At the end of four weeks’ time, horses so treated may be returned to service, but the full beneficial effect of such treatment is not experienced until several months’ time have elapsed. Where good facilities for executing a careful technic in every detail are at hand, incision of the tarsal sheath, evacuation of its contents and uniting its walls again by means of sutures and providing for drainage with a suitable drainage tube, may be practiced.

This manner of treatment has been satisfactory in the hands of a number of surgeons. Capped Hock. Enlargements which occur upon the summit of the os calcis, whether hypertrophy of the skin and subcuticular fascia, the result of injury or repeated vesication, distension of the subcutaneous bursa or injury to the superficial flexor tendon (perforatus) or its sheath, are generally known as capped hock.

However, the term should be restricted to use in reference to distensions of synovial structures of that region. Etiology and Occurrence.—Usually there occurs a hygromatous involvement of the subcutaneous bursa due to contusion.

As in bog spavin, following certain infectious diseases (influenza, purpura hemorrhagica, etc.) there remains a distended condition of the subcutaneous bursa, after swelling of the member has subsided.

In feeding pens where numbers of young mules are kept in crowded quarters many cases may be observed.

In some instances where violent contusions result from kicking cross-bars of wagon shafts (by nymphomaniacs or in habitual kickers where there is opportunity for doing such injury) the superficial flexor tendon and its synovial apparatus are injured and a more serious condition may result. Symptomatology.—In acute and extensive inflammation of the parts, lameness is present, but in the average case no inconvenience to the subject results.

The prominent site of the affection is cause for an unsightly blemish.

This is undesirable, particularly in light-harness or saddle horses.

These affections are characterized by a fluctuating mass which has a thin wall and in all cases of long standing the condition is painless. By careful palpation one may readily distinguish between a hygromatous condition of the superficial bursa and involvement of the underlying structures.

Affection of the expanded portion of the flexor tendon and contiguous structures makes for an organized mass of tissue which is somewhat dense and in some instances painful to the subject when manipulated.

This is particularly noticeable in cases where the parts are regularly and repeatedly injured as in habitual kickers. HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\images\\img60-full.jpg” INCLUDEPICTURE “../AppData/Local/Temp/Horse_lameness/images/img60.jpg” \* MERGEFORMATINET 
Fig. 60—”Capped hock.” Distension of the bursa over the summit of the os calcis. Treatment.—In acute inflammation, antiphlogistic applications are indicated and the subject must be kept quiet.

The matter of bandaging the hock is a difficult problem in some cases and needs be done with care.

As has been previously stated in this volume, the tarsus needs to be well padded with cotton before the bandages are applied and only a moderate degree of tension is employed in applying the bandages lest anemic-necrosis result from pressure.

In distension of the superficial bursa, after clipping the hair over a liberal area and preparing the skin by thoroughly cleansing and painting with tincture of iodin, the capsule is incised with a bistoury.

An incision about an inch in length, situated low enough to provide drainage, is made through the tissues and the contents are evacuated.

Tincture of iodin is injected into the cavity and the parts are covered with cotton and bandaged.

No after-care is necessary except to retain the dressing in position, which is not difficult in the average case if the subject is kept tied.

If much resistance is exhibited, such as extreme flexion of the bandaged hock, the animal may be put in a sling and little if any objection to the bandage will be offered thereafter.

The wound may be dressed at the end of forty-eight hours and no redressing will be necessary in the average instance if infection is not present.

But slight local disturbance and little distress to the subject result in cases so treated even when infection occurs, but a good technic is possible of execution in most instances and no infection should take place. The surgical wound heals in two or three weeks and inflammation gradually subsides.

Bandages are retained one or two weeks, as the case may require, and subsequently a good wound lotion may be employed several times daily.

A good lotion for such cases as well as in many others has long been employed with success by Dr.

A.

Trickett of Kansas City.

It consists of approximately equal parts of glycerin, alcohol and distilled extract of witch hazel, to which is added liquor cresolis compositus, two percent, and coloring matter q.s. Complete resolution does not occur in the average case.

There remains some hyperplastic tissue and even where the enlargement is slight, the prominent situation of the affection precludes its being unnoticed. In disease of the flexor tendon and its bursa where contiguous inflammation of tissue is present, the parts are blistered or fired.

Line firing is beneficial in such instances but in all cases the cause is to be removed if possible. Rupture and Division of the Long Digital Extensor
(Extensor Pedis). Etiology and Occurrence.—Because of the fact that the long digital extensor is the only extensor of the phalanges of the pelvic limb, its rupture or division constitutes a troublesome condition, which in some cases does not readily respond to treatment. Rupture of this tendon may occur during work on rough and uneven roads, particularly in range horses that are ridden over ground that is burrowed by gophers or prairie dogs; in such cases, horses are apt to suddenly and violently turn the foot in position of volar flexion, thereby causing undue strain to the digital extensor and its rupture sometimes follows.

In foals of one or two days of age, this tendon is sometimes found parted or ruptured and the condition may be bilateral. As the result of accidents, the digital extensor may be divided and when the wound becomes contaminated, as it does because of the marked volar flexion (knuckling) which occurs during the course of this affection, regeneration of tissue is checked and recovery is tardy. Symptomatology.—There is no interference with ability to sustain weight in such cases, when the foot is placed in normal position; but immediately upon attempting to walk, the toe is dragged, and if weight is borne with the affected member, it comes upon the anterior face of the fetlock.

The flexors are not antagonized and if there be an open wound the parts soon become contaminated; or, in rupture, if animals travel about very much, there soon occurs necrosis of the tissues of the anterior fetlock region and the condition is rendered incurable.

Cases are reported of animals that have suffered rupture of the long digital extensor and the subjects learned to throw the member forward during extension, substituting for the extensor tendon the pendulum-like momentum which the foot affords when so employed; and a walking and even a trotting pace was possible without doing injury to the fetlock region. Where a subcutaneous division exists as in rupture, the divided ends of the tendon may be definitely recognized by palpation. Treatment.—Subjects are best put in slings and kept so confined until regeneration of tendinous structures has been completed.

This requires from six weeks to two months’ time.

In addition, the extremity is kept in a state of extension by means of suitable splints and shoes,—a shoe equipped with an extension at the toe and perforated so that a steel brace may be hooked into the perforation and the brace fashioned to be buckled to the upper metatarsal region.

When braces are placed in front of the foot, great care is necessary in properly padding the member with cotton lest sloughing from pressure occurs at the coronet; but this does not apply in rupture of extensors so much as where flexors are ruptured. Open wounds are treated along general surgical lines, dressed as frequently as occasion demands, and recovery will be complete in a few months’ time unless much of the tendon has been destroyed.

In one instance, the author had occasion to observe such a condition, which, because of the extensive destruction of tendon and lack of facilities for giving proper attention to the subject, results were so unfavorable that it was deemed necessary to destroy the animal. — Arthritis, metastatic, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_25” 25 Arthritis of the fetlock joint, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_152” 152 Arthritis, rheumatic, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_26” 26 Arthritis, scapulohumeral, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_65” 65 Arthritis, tarsal, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_225” 225 Arthritis, traumatic, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_22” 22 Articular ringbone, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_121” 121 Articulation, femeropelvic, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_185” 185 Articulation, metacarpophalangeal, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_58” 58 Articulation, scapulohumeral, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_55” 55 Aspiration-and-injection treatment of bog spavin, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_244” 244 Aspiration-and-injection treatment of capped hock, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_252” 252 Aspiration-and-injection treatment of thoroughpin, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_250” 250 Astragalus, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_190” 190 Astragalus, fracture of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_230” 230 Attitude of the subject, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_41” 41 Atrophy of the quadriceps muscles, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_205” 205 Atrophy, shoulder, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_73” 73 B Biceps brachii, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_58” 58, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_65” 65, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_68” 68, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_69” 69 Bicipital bursa, inflammation of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_68” 68 Blood vessels, affections of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_31” 31 Bog spavin, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_242” 242 Bog spavin, aspiration-and-injection treatment of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_244” 244 Bog spavin, line firing for, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Bog spavin, vesication for, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Bone spavin, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_235” 235 Bones, degenerative changes in, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_16” 16 Bones, tarsal, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_190” 190 Bossi’s double tarsal neurectomy, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_242” 242 Brachial artery, thrombosis of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_81” 81 Brachial paralysis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_77” 77 Bursa intertubercularis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_62” 62, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_69” 69 Bursa podotrochlearis, inflammation of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_157” 157 Bursae, affections of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_27” 27 Bursitis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_27” 27, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_104” 104 Bursitis, infectious, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_28” 28 Bursitis in the fetlock region, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_150” 150 Bursitis intertubercularis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_68” 68 Bursitis, noninfectious, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_28” 28 C — Ligaments, mesial tarsal, sprains of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_232” 232 Ligaments of pastern proximal interphalangeal joint, inflammation of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_129” 129 Ligaments, patellar, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_188” 188 Ligaments, plantar, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_190” 190 Ligament, pubiofemoral, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_185” 185 Ligament, superior check, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_58” 58 Ligament, suspensory, rupture of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_146” 146 Ligaments, volar, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_129” 129 Ligament, volar-carpal or annular, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_58” 58 Ligation of the saphenous vein, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Line firing for bog spavin, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Longitudinal fractures, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_18” 18 Lumbosacral plexus, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_204” 204 Luxation of the carpal bones, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_96” 96 Luxation of the femur, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_201” 201 Luxation of fetlock joint, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_125” 125 Luxation of the patella, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_213” 213 Luxation of the patella, outward, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_215” 215 Luxation of the patella, upward, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_214” 214 Luxation of scapulohumeral joint, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_67” 67 Luxations, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_21” 21 Luxations, fixed, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_21” 21 Luxations, temporary, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_21” 21 Lymph vessels and glands, affections of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_32” 32 Lymphangitis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_32” 32 Lymphangitis, infectious, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_257” 257 — Thrombosis, iliac, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_209” 209 Thrombosis of the brachial artery, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_81” 81 Tibia, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_188” 188 Tibia, fracture of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_222” 222 Tibial tarsal bone, fracture of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_230” 230 Tibialis anticus muscle, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_193” 193 Tibioastragular joint, distension of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_242” 242 Transverse fractures, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_18” 18 Traumatic arthritis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_22” 22 Traumatic ringbone, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_122” 122 Treatment of bog spavin by aspiration and injection, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_244” 244 Treatment of capped hock by aspiration and injection, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_252” 252 Treatment of ringbone by firing, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_123” 123 Treatment of thoroughpin by aspiration and injection, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_250” 250 Triceps brachii, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_58” 58 Triceps brachii, contusions of, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_71” 71 Triceps extensor brachii, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_71” 71 Trochanteric bursa, inflammation of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_204” 204 True crepitation, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_47” 47 U Ulna, fracture of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_86” 86 Ulnaris lateralis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_94” 94 Upward luxation of the patella, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_214” 214 V Vein, saphenous, ligation of the, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Vesication for bog spavin, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Vessignon chevillé, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_246” 246 Visual examination, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_39” 39 Volar-carpal ligament, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_58” 58 Volar ligaments, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_129” 129 W Wounds, calk, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_170” 170 Wounds, contusive, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_85” 85 Wounds from interfering, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_255” 255 Wounds of anterior brachial region, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_90” 90 Wounds of coronary region, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_170” 170 Wounds of scapulohumeral joint, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_67” 67 Wounds of tendo achillis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_224” 224 Wounds, penetrative, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_85” 85 X X-ray diagnosis, HYPERLINK “file:///C:\\Users\\Flori\\Desktop\\Horse_lameness\\16370-h.htm” \l “Page_179” 179

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