ry is used. Line-firing is preferable. The
subject is given a month or six weeks rest and one may be guided by the
presence or absence of lameness as to whether improvement or recovery is
taking place.

Old chronic cases, and particularly those where there are considerable
induration and fibrous organization of tissue surrounding the joint, are
not to be benefited by treatment.

The chief consideration in handling sesamoiditis is checking
inflammation as early as possible and preventing, if this can be done,
the erosion of articular surfaces. If destruction of any part of the
articular surfaces can be prevented and the patient allowed ample time
for complete resolution of the affected parts to occur, permanent relief
is possible.

Fracture of the Proximal Sesamoids.

Etiology and Occurrence.--Fracture of the proximal sesamoid bones is
caused by violent strain when there exists _fragilitas osseum_, or by
contusions. The author treated a case where fracture of one sesamoid was
occasioned by a horse receiving a puncture wound wherein the sharp end
of a steel bar was protruding from the ground where it was firmly
embedded. The subject in this case was injured while being driven along
a country road. Frost[23] reports simultaneous fracture of all of the
proximal sesamoids occurring in a sixteen-year-old pony. The condition
is of rather common occurrence in some countries because of the fragile
condition of horses' bones.

Symptomatology.--If the parts can be examined before extravasation of
blood and swelling mask the condition, crepitation may be detected. In
other instances, it is possible to note a displacement of parts of the
sesamoid bones--this in horizontal fracture. There occurs more or less
descent of the fetlock which must not be attributed to rupture of the
superficial flexor tendon (perforatus). By outlining the course of this
tendon with the fingers, when it is passively tensed sufficiently to
follow its course, one may exclude rupture of the superficial flexor.
Finding the suspensory ligament intact from its origin to the sesamoid
attachments, one may also eliminate rupture of this structure as a cause
of the trouble. Needless to say, marked lameness and swelling of the
fetlock soon take place. The condition is painful, and ordinarily,
recovery is impossible.

Treatment.--Where treatment is attempted, immobilization as in
luxation is in order. The patient's comfort is sought, and if the
fractured part