If, on the other hand, the puncture extends into the navicular bursa, the radical operation is perhaps indicated, though not until one is sure that infection of the bursa and serious consequences are to follow if this operation is not performed.  Detailed description of the technic of this operation belongs to the realm of surgery and a good discussion of it is to be found in William’s work on veterinary surgical and obstetrical operations.

One may summarize the discussion of treatment of nail puncture by saying that emergency care as herein described is of first consideration.  In every case an immunizing dose of anti-tetanic serum should be given.  Subsequently, the method employed must suit the character of the wound, existing facilities for handling the subject and the skill and aptitude of the practitioner.

FOOTNOTES: 

[Footnote 5:  Manual of Veterinary Physiology, by Major-General F. Smith, page 590.]

[Footnote 6:  Manual of Veterinary Physiology by Major-General F. Smith, page 589.]

[Footnote 7:  Regional Veterinary Surgery and Operative Technique, Jno.  A.W.  Dollar, M.R.C.V.S., F.R.S.E., M.R.I., page 765.]

[Footnote 8:  Dr. Roscoe R. Bell in the Proceedings, N.Y.  State Veterinary Medical Society, 1899.]

[Footnote 9:  American Veterinary Review, Vol. 35, P. 456.]

[Footnote 10:  “Radial Paralysis and Its Treatment by Mechanical Fixation of Knee and Ankle,” Geo. H. Berns, D.V.S.  Proceedings of the American Veterinary Medical Association, 1912, p. 219.]

[Footnote 11:  As quoted by Berns, in Radial Paralysis, etc., Proceedings of the A.V.M.A., 1912.]

[Footnote 12:  Veterinary Surgical Operations, by L.A.  Merillat, V.S., p. 507.]

[Footnote 13:  A paper presented before the Illinois Veterinary Medical Assn. by Dr. H. Thompson of Paxton, Ill., American Veterinary Review, Vol. 15, p. 134.]

[Footnote 14:  “Fractures in Foals,” by Dr. Wilfred Walters, M.R.C.V.S., American Journal of Veterinary Medicine, Vol. 8, p. 669.]

[Footnote 15:  American Veterinary Review, Vol. 26, p. 1068.]

[Footnote 16:  Fractures, by H. Thompson, Paxton, Ill., American Veterinary Review, Vol. 15, p. 134.]

[Footnote 17:  Veterinary Surgical Operations, by L.A.  Merillat, Vol. 3, p. 198.]

[Footnote 18:  Wilfred Walters, American Journal of Veterinary Medicine, Vol. 8, p. 606.]

[Footnote 19:  J.N.  Frost, assistant professor of Surgery, Veterinary Dept., Cornell University, in “Wound Treatment,” page 159.]

[Footnote 20:  Open Joints and Their Treatment in my practice, by J.V.  Lacroix, American Journal of Veterinary Medicine, Vol. 5, page 203.]

[Footnote 21:  Regional Veterinary Surgery Moeller—­Dollar, page 605.]

[Footnote 22:  Extract from Receuil de Medecine Veterinaire in Ameircan Veterinary Review, Vol. 23, p. 893.]