In cases where there exists no evidence of open joint or open tendon sheath as judged by the site of the puncture and degree of lameness present (after having thoroughly cleansed the solar surface of the foot and enlarged the opening in the nonsensitive sole) a little phenol is introduced into the wound.  In such cases, where it is possible for the antiseptic to contact every part of wound surface to the extreme depths of the puncture, infection is prevented when such treatment is promptly administered.  This may be considered as first aid, or emergency care, and is indicated in all wounds of the foot whether the injury be serious or almost insignificant.

Subsequently one of two general courses may be pursued in the treatment of cases of nail puncture.  One, by the employment of means to keep the wound patent and injection of suitable antiseptics, or agents that are more or less caustic in conjunction with strict observance of asepsis and wound protection.  The other method consists in prompt establishment of drainage by surgical means and includes exploration and curettage.

The first method is better adapted to the use of the average general practitioner and he would do well to keep the opening in the nonsensitive structures patent.  By introducing equal parts of tincture of iodin and glycerin daily, good results will follow in most instances.  The wound is protected in unshod horses, either by completely bandaging the foot and retaining, in contact with the wound, cotton that is saturated with iodin and glycerin, or, if a minor injury exists, the moderately enlarged opening in the nonsensitive sole or frog, which has been moistened with the antiseptic, is packed with a very small quantity of cotton.  A little practice in this mode of closing benign puncture wounds will enable the practitioner to successfully protect the sensitive parts in the treatment of such cases in unshod country horses.

When the condition progresses favorably the wound may be dressed every second day or twice weekly, and in the course of from two to six weeks recovery should be complete.

If the practitioner is somewhat proficient as a surgeon, and has at his command facilities for doing surgery, the second method is preferable in many cases.  By using a local anesthetic on the plantar nerves and confining the subject on an operating table, restraint should be perfect.  The solar surface of the foot is first thoroughly cleansed, the puncture wound is enlarged in the nonsensitive structures and the parts are then moistened with phenol or other suitable antiseptics.  By means of a small probe the puncture is explored and, depending on the character of the wound and the structures involved, surgical intervention is varied to suit the case.  If necessary, all of the insensitive frog is removed, and in wounds affecting the region of the heel the tissues may be incised from the puncture outward dividing all of the tissues outward and backward to the surface.  A suitable surgical dressing is then applied.