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The presence of fat and bony particles in the pus confirms the medullary origin of the suppuration. If an incision is made, the periosteum is found to be raised from the bone; the extent of the bare bone will be found to correspond fairly accurately with the extent of the lesion in the marrow. Local Complications.
They are usually sub-periosteal and when the periosteum is left intact or nearly so, no crepitation is discernible. If this fracture is simple, prompt recovery may be expected. Bones of young animals, because they do not contain proportionately as much mineral substance as do bones of adults, are more resilient and less apt to become completely fractured.
The diaphysis is also nourished by numerous blood vessels from the periosteum, which penetrate the cortex through the Haversian canals and anastomose with those derived from the nutrient artery. The epiphyses are nourished by a separate system of blood vessels, derived from the arteries which supply the adjacent joint. The veins of the marrow are of large calibre and are devoid of valves.
Syphilitic osteo-arthritis results from a gumma in the periosteum or marrow of one of the adjacent bones. There is gradual enlargement of one of the bones, the patient complains of pains, which are worst at night. The disease may extend to the synovial membrane and be attended with effusion into the joint, or it may erupt on the periosteal surface and invade the skin, forming one or more sinuses.
When hyperostosis and sclerosis of the bone is attended with severe pain which does not yield to blistering, the periosteum may be incised and the sclerosed bone perforated with a drill or trephine.
Poncet hastened a cure in a case of necrosis with partial destruction of the periosteum by inserting grafts taken from the bones of a dead infant and from a kid. Ricketts speaks of bone-grafting and the use of ivory, and remarks that Poncet of Lyons restored a tibia in nine months by grafting to the superior articular surface.
Interfering in the hindfeet may be stopped by noting the character of the animal's gait and the portion of the wall that strikes the part, and by practising intelligent methods of shoeing. Slight injuries should be treated by the application of antiseptic powders. The treatment for injuries to the periosteum is the same as that recommended for splints.
The process may remain localised to the ossifying junction, but usually spreads along the medullary canal for a varying distance, and also extends to the periosteum by way of the enlarged Haversian canals. The pus accumulates under the periosteum and lifts it up from the bone. The extent of spread in the medullary canal and beneath the periosteum is in close correspondence.
A tumour of bone may grow from the cellular elements of the periosteum, the marrow, or the epiphysial cartilage. Primary tumours are of the connective-tissue type, and are usually solitary, although certain forms, such as the chondroma, may be multiple from the outset. Periosteal tumours are at first situated on one side of the bone, but as they grow they tend to surround it completely.
It is supposed that conditions in which the periosteum is exposed are favorable to the progress of the disease, and, according to Hirt, workmen with diseased teeth are affected three times as readily as those with healthy teeth, and are therefore carefully excluded from some of the factories in America.
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