vided all of the substance of the extensor tendons, it is, of course,
impossible for the subject to advance the leg; but where lacerated
wounds involve only a part of the extensor apparatus of the foreleg, not
so much inconvenience is evident, unless the wound is seriously infected
and inflammation involves contiguous structures. Therefore, in many
instances, lameness is more pronounced in contusions of the anterior
brachial region than where tissues have been divided more or less
keenly.
In every instance diagnosis is easily established. The injury is quite
evident, and the manner of locomotion is not in itself an essential
feature to be considered in a discussion of symptoms. Where a contusion
of the anterior brachial structures occurs, there is, in addition to
lameness, swelling which is painful because of the pressure occasioned
by the heavy non-yielding brachial fascia. And where suppuration occurs,
there is then an intensely painful condition which is not relieved until
pus has been evacuated. Rather frequently, drainage for wound secretions
is a difficult problem, and approximation of the divided ends of muscles
is always difficult to maintain.
Treatment.--Contused wounds of the anterior brachial region are
treated along usual lines; that is, attempt is made to stimulate prompt
resolution. Hot or cold applications are employed throughout the acute
stage of the affection. Complete rest is provided for until all pain has
subsided. Later, stimulating liniments are beneficial.
Where no injury is done the periosteum or bone, complete resorption of
all products of inflammation usually occurs, though in many instances,
this is tardy--six weeks or more are sometimes required for recovery to
take place.
If suppuration occurs, it is necessary to provide for drainage as soon
as it is possible to distinguish the presence of pus. Due regard is
given the manner of establishing drainage because of the usual existence
of sub-fascial fistulae. In these cases, one avoids injecting solutions
of aqueous antiseptics. By gently compressing the parts, pus is caused
to drain out and in enforcing a moderate amount of exercise at a walk,
when lameness is not intense, drainage is maintained. Cotton packs,
moistened with hot antiseptic solutions, and kept around the forearm for
several hours daily, are helpful because drainage is facilitated, and
resolution is stimulated by the increase of blood thus attracted to the
parts, and pain
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