Fractures of Extremities.
/. â€” Scapula.
Lying obliquely on the lateral face of the thorax and protected by a
muscular layer, the scapula is relatively little exposed to fractures. Falls
and contusions are the most frequent causes. They occur on the acromion,
one of the superior angles or the body of the bone and most commonly the
Fracture of the acromion is manifested by a circumscribed tumefaction,
often very painful, situated a little below the middle part of the scapula.
By the application of a pitch bandage or a blister, it is rare if consolida-
tion takes place : often the broken portion of the bone necroses and acts
as foreign body ; an abscess forms after a few days ; punctured, it gives
escape to a watery pus of bad nature ; the fistula may cicatrize and re-
appear later on. The observations of Hartenstein have shown the ineffi-
cacy of caustic injections (Villate solution, tincture of iodine, sulfate of
zinc), of continued irrigation and of cauterization. Enlarge the wound
and extract the mortified bony piece are the indications. Antiseptic
injections insure recovery in a short time.
\n fracture of one of the superior angles of the bone, there takes place,
as in most cases of fracture of the olecranon and of the angle of the hip,
a marked displacement, due to the contraction of the muscles attached
on those angles. Reduction is impossible, but by blisterings and rest,
recovery is easily obtained. The fragment becomes fixed in the place it
has taken, the inflammatory phenomena subside, the lameness disappears.
More serious are the fractures of the body and of the neck. Most
ordinarily the bone is divided transversely to its long axis, sometimes
parallel to it, and then the glenoid cavity is generally involved. The
prognosis is so much more serious that the fracture is more inferior.
Pains are less acute and the separation of the ' edges of the fracture
less accused when the injury involves the body of the bone. Great
pain, excessive lameness, lancinating sufferings are bad omens. When
the fracture is comminuted or intra-articular, arthritis ^and purulent
infection may be looked for ; yet, regular consolidation may occur, as
shown by the cases of Delaporte and Plouvier. Recovery, however, de-
mands a long time : often the callus is very large, there is atrophy of the
muscles and the lameness persists. Godine, Zundel, Schachinger, have
obtained in horses recovery of the fracture of the neck. We have alsa
treated with success a large draught horse of six years. Fracture above the
neck unites easily in cattle.
" Reduction of fracture of the scapula should be made with the animal
standing ; the little displacement of the fragments makes it easy ; to do
it, it suffices to keep the leg in extension and press in, with the hand close,
the protruding portion of the bone " (Delwart). Contention is not indis-
pensable (Delaporte and Plouvier). Furlanetto only applied a blister
upon the shoulder of an eight-months' bull ; the lameness did not disap-
pear ; the animal was used for breeding.
To keep the fragments in firm position, various apparatus have been
recommended. The iron splint of Bourgelat is composed of a metallic
band thrown over the withers
and covers both shoulders.
That which rests upon the
injured one terminates by a
is secured by screws a piece of
felt, which presses upon the
center of the fractured region.
Godine has obtained good
results with the following :
After application on the
shoulder of a mixture of pitch
and Venice turpentine, wide
bands are laid from the
withers, across the shoulder,
chest, axilla, twisting round
the elbow, crossing the scapula
again from downwards up-
wards to the withers, going
over the opposite leg and
enveloping it in the same way,
to return to the fractured
shoulder, upon which was laid an emplastic mixture at each passage of the
band. This was continued until the dressing had acquired a certain
Delwart, in his method, used bands of linen, three or four fingers wide, which
he dipped in a mixture of pitch and Venice turpentine. A certain number
of rolls are placed round the arm and brought back to the superior part
of the shoulder, crossing each other at the point of fracture. Others,
starting from the withers, run down the shoulder, surround the shoulder-
joint and go to be fixed, some on the chest, others on the forearm.
From the knee upwards, this region is also enveloped by rollers, others
from downwards upwards : to give more solidity to the dressing, a new-
Fig. 98. â€” Bandage for fractures of the scapular,
and for those of the humerus. (Delwart.
434 VETERINARY SURGICAL THERAPEUTICS.
series of bands is applied which starts from the posterior part of the-
shoulder, and goes to be fixed upon the opposite shoulder after surround-
ing the chest. A last layer of rollers surrounds the thorax, and reinforces
the posterior part of the dressing. Although the author advises to have
the animal in liberty, to allow him to lie down and get up, it is better to
place him in slings : a greater immobility of the part is obtained, the
callus is smaller.
Lafosse has advised the use of a bandage made of a light collar and a
light saddle, with its sides extended downwards to the back of the elbow.
The two are united together by straps supporting padding and splints
covered with stitching mixtures which are laid over the surface of the
Once the contention insured, as much as possible, the subject should be
placed in slings ; if not that, a good soft bed will be given for him to lie
on. As long as the work of repair lasts, the bandage shall be watched
and if necessary consolidated with new bands of rollers and pitch. After
six weeks, the whole thing will be softened with warm water ; for a week
or two, the region should be massaged, hot lotions should be applied, and
if the callus is very large cauterization should be resorted to.
In small animals, when the inertia of the leg, the sensibility of the
shoulder, the crepitation, indicate fracture of the scapula, the animal is
cast on the opposite side and the leg is held in extension. The manipula-
tions for reduction are easy ; in general there is but little displacement.
Coaptation obtained, an immovable dressing is applied, analogous to that
used in horses. Bands dipped in- pitch and passed first under the arm
come across the shoulder â€¢ others surround the superior part of the fore-
arm ; then longer ones are placed which from the withers are fixed down-
wards on the external surface of the forearm and point of the sternum. A
few surround the chest as belt ; others, fixed on the base of the neck,
consolidate the whole apparatus. It is good to wrap up the shoulder,
thorax and base of the neck with a kind of apron, which prevents the litter
from sticking to the bandage. The patient is left in liberty. After
twenty or thirty days the apparatus is taken off ; the callus is suflficiently
firm. Massage and passive motions will prevent ankylosis and amyotrophy.
Lameness sometimes remains for months.
In young dogs, epiphysar detachments of the scapula or humerus are
observed. Their treatment is that of fractures, but articular lesions are
likely to complicate the injury and impede the function of the leg.
Open fractures demand the destroying of large animals. In the smaller
species, a penetrated immovable bandage or a wadded dressing should be
applied and the wound treated antiseptically. (See Open Fj-actures).
//. â€” Humerus.
Fractures of the humerus are ordinarily the resuhs of traumatic actions
or falls, and sometimes of muscular contractions. Rossignol, Ernes,
Goubaux, have seen fractures take place while walking without excessive
effort.^ They are in general twice as frequent on the epiphysis as on the
body of the bone. Stockfleth has collected nineteen cases of fractures of
the extremities and only seven of the body. Whether epiphysar or
diaphysar, recovery is possible, specially in small animals. Stockfleth and
jMoller have treated successfully dogs affected with bilateral condyloid
fractures. But prognosis is serious for animals of large species ; though in
few exceptional cases, where the displacement and mobility of the
extremities were not excessive, consolidation was obtained (Henon, Cholet,
Lafosse, Lafontaine, Furlanetto). Lafosse has watched a case which, left
to himself, was able to resume work in a stage-coach after three months.
A similar result occurred in a six weeks colt. In the Veterinarian (1855)
is found the observation of a four-year-old horse which recovered of a
fracture of the humerus without the application of bandage ; the animal
was very quiet, the fracture simple and with good adaption of the extrem-
ities ; the animal was placed in slings ; after three months he walked easily.
When the ends of the bone remain close to each other, consolidation
may take place without bandage ; but generally it is an oblique iracture^
comminuted ; the fragments overlap, contention is dififlcult.
Black pitch has often been utilized for the making of bandages in fractures
of the humerus. They can be alternate with mixture of pitch and oakum
(Baritaud), or the method of Delwart (See I'racture of the Scapula).
With this bandage, Furlanetto has cured a steer two years old and several
young ruminants. He always operated with the animal standing. The
patients were allowed to lie down and get up during the whole treat-
Lafontaine used a mixture of alcohol (i liter) and crystallized alum
(500 grammes), which he boiled down to the consistency of syrup; he also
prepared a mixture of equal parts of rosin and black pitch. Having a nine-
year-old horse to treat, suffering with fracture of the upper part of the
humerus, he surrounded the leg with oakum impregnated with the solu-
tion of alum ; placed two splints, covered with a coat of the mixture of
rosin and pitch, crossed in X over the fracture, and two others, also covered
with the same mixture, alongside the leg ; one, the external, extended
to the withers ; the other, internal, as far as the axilla. Circular bands,.
^ Burchsted has recorded one case in a fifteen months' bull injured during the act
of copulation. â€” American Vet. Review, vol. 22, p. 571.
436 VETERINARY SURGICAL THERAPEUTICS.
glued together with the mixture, were applied from the foot upwarcs
to the shoulder, and passing then over the withers, from the front back-
wards, and from backward forwards, were at last secured at the point of
fracture with the adhesive mixture. The animal was left to himself. The
twenty-fourth day the animal rested on his leg, the apparatus was taken
oK the forty-sixth day. After two months and a half he resumed his work
as a cavalry horse. Recovery was perfect.
Beaufils has described a method of treating fractures of the humerus
and of the femur, which has given him good results in goats and which he
believes is applicable to horses. With a long band of linen, he keeps the
injured leg against the parts contiguous to it. Let us suppose it is a small
animal which has a fracture of the left humerus. The animal secured in
the standing position, the operator takes hold, with the right hand, of the
forearm below the elbow, then with the left hand, raising the arm of the
animal by its middle, he carries it in an upward motion, so as to bring
it alongside the corresponding side of the chest, where he holds it. The
band is rolled a certain number of times round the chest and the arm
is kept in the new position. To have a solid contention, however, it is
necessary to involve in the bandaging the elbow, the superior part of the
forearm and the shoulder ; other circular rolls serve to support the lower
parts of the leg. Bands with pitch covering the whole, consolidate the
apparatus. A large sized animal must be placed in slings.
Tried at the Lyons clinic, it proved successful only in a goat. Dogs
would not keep it.
As rightly remarked by Lafosse, fractures of the humerus in small
animals recover well. The muscles of the arm and shoulder are sufificient
to hold the fragments in position. With simple fracture, without great
â– displacement, a pitch plaster is advisable. When the more movable ends
are likely to overlap each other, the bandage of Delwart is recommended
for fractures of the superior part of the bone ; for those of the lower part
the method described by Peuch and Toussaint in their Traite de Chinir-
gie is indicated. It is as follows : The material necessary consists of :
Fine oakum arranged in small pads, dressing linen or wide bandages,
a mixture of pitch and turpentine, a solution of dextrine or of silicate of
soda, and splints, made of pasteboard and cut in the pattern of the leg.
One of these will be placed on the inner side of the leg and extend from
the axilla to the foot ; the other, placed on the outside, must reach the
shoulder joint. All being ready, the dog, muzzled, laid on a table on the
opposite side to the diseased one, is held quiet. The coaptation obtained,
to remove all irregularities of surface and give the leg the form of a per-
fect cylinder, the operator envelops the fractured region and the other parts of
the leg with oakum dipped in the sticking mixture of pitch or of dextrine.
The splints, also covered with the same, ace placed over the oakum, and
methodically, from below upwards, the roller is applied from the lower
â– end of the leg, carefully avoiding excessive pressure. A thick coat of
oakum generally protects agamst gangrenous accidents.
The application of this roller demands the making of a great many
*' tenverses" twisting the band on half turn, specially at the elbow, so as
to insure a close application of the roller, which will be secured to-
gether by the sticking mixture, to the oakum, to the splints ; or again
may be sewed up with needles and thread.
During the first days, the patient must be watched closely. High fever,
anorexia, groans, indicate too much pressure. The cutting of a few turns
â– of the band permits to examine the condition of the toes, which sometimes
are greatly tumefied or already covered with blisters, or almost mortified*
In this semi-sloughing region, the circulation may be restored by sup-
pression of the bandage. But gangrenous accidents are not much to
Tdc feared when the apparatus has been properly applied. They occur
only in cases where the pressure is too great at the seat of the fracture
and when the bandage does not cover the whole length of the leg.
This method, so successful with small animals, differs little from that of
Lafontaine, and it is not surprising if that operator had obtained good
results with it in horses and ruminants.
For large species, as soon as the standing is firm, continued, and the
pulsations of the collateral artery of the cannon are felt, Moller recom-
mends to leave the animal at liberty. The bandage is kept in place for
six weeks at least.
With dogs, it is ordinarily removed after three weeks or a month. Gen-
erally the bony fragments are then firmly united, and it is rare if another
bandage has to be applied. During convalescence, douches and massage
^re indicated. Locomotion is painful for some time, but by degrees re-
gains its freedom.
///. â€” Radius.
Well separated from the trunk and biit little protected in the greatest
part of its internal face, the radius is frequently subjected to fractures,
ordinarily due to traumatisms, falls and sometimes muscular contraction.
Cases are commonly recorded. Lafosse, Portal, Tassy, Bonnefond, Ros-
signol, S. Bouley, Degive, Bringard have reported interesting instances.'
1 Walrath has recorded the case of a performing elephant which after an exercise of
rope-walking was found lame on the inner foreleg with a fracture of the inner forearm.
He was destroyed and it was found that the ulna was fractured transversely across
its lower third and the radius also in several pieces. â€” Am. Vet. Review, vol. to, p.
438 VETERINARY SURGICAL THERAPEUTICS.
Notwithstanding their serious nature, numerous cases have been fol-
lowed by recovery. Unfortunately, the uncertainty of the result has-
decided against the treatment, and animals are often destroyed.
As for all other fractures of the extremities, the opinion of the practi-
tioners, in the use of slings, is divided. Some, like Tassy and Portal,
reject them entirely; they say it is dangerous, tiresome to the pati-
ents, causing gangrenous accidents and fever, which induce the animals
to hang in them. Yet most veterinarians continue to employ them.
It is only in exceptional cases, with very irritable subjects, as the
stallion " Physician," treated by S. Bouley, that it is better to leave
Therefore, in general, the fracture must be reduced, dressing of con-
tention applied and the patient slung. If there is overlapping of the
fragments, he must be cast and placed under anesthesia, being careful, in
reducing the fracture, to give the foot a good direction.
With a simple wadded dressing, well applied, Salchow has obtained a
complete success. Portal has recommended pitch. The coaptation made,,
the fractured region was coated in its whole extent with liquefied pitch, upon
â– which a thick coat of oakum was laid ; four wooden splints held with turns
of rollers finished the dressing. With this bandage. Portal has cured a mule
affected with an open comminuted fracture. After two months, the sub-
ject was slightly lame ; a points firing was applied over the seat of the
fracture, the lameness disappeared and the patient resumed work.
In a horse having a complete fracture of the radius, without displace-
ment, Tassy enveloped the leg (from the axilla to the middle of the can-
non) with oakum dipped into a mixture of eggs and burnt alum. Four
â– wooden splints, wrapped up in oakum and covered with Venice turpentine,
were placed on the four faces of the leg, the external one extending from
the shoulder to the coronet, and the whole was held in place by turns of
rollers sewed together. The patient, possessing an extraordinary instinct
of preservation, would lie down carefully, without putting the slightest
weight on its fractured leg. After thirty-six days, the apparatus was taken
off; the callus was very large and made the animal very lame. Firing
was necessary. ' The lameness disappeared entirely.
Rossignol, treating a simple fracture of the radius in a four years colt,
first surrounded the leg with oakum dipped in a mixture of starch, white of
eggs and powdered alum. Four wooden splints, going not beyond the
extremities of the forearm, were fixed by turns of a roller, impregnated
with the same sticking mixture. A wound of the external face of the knee
â– was dressed with tincture of aloes, through a window made in the corre-
sponding part of the bandage. This dressing was taken off the fortieth
day ; the callus was very large and the forearm atrophied, but, after a.
"few months, the muscles regained their ordinary size and the lameness
In a horse having an oblique fracture, Dehvart applied a dressing that
he described as follows : The fracture being reduced, the animal standing,
wide bands of linen covered with resinous mixture were applied from in-
wards outwards, upon the fractured spot, and drawn, crossing each other,
over the external face of the forearm and of the shoulder ; similar bands
were arranged from the middle of the cannon to the level of the fracture ;
a pad of oakum laid on the internal face of the olecranon was fixed by two
long bands crossing each other over the shoulder and secured on the sides
of the withers and of the neck ; and then a wooden splint, extending
from the foot to the superior part of the shoulder, was fixed by circular
turns of a roller. The animal was placed in slings. Four weeks after the
bandage was taken off; the horse was very lame. Four months later, his
gait was normal.
For fractures of the radius, Lafontaine has advocated the same appara-
tus as the one he used for those of the humerus.
Already in 1847, Bonnefond recommended the plastered bandage. On
a fifteen-year-old mule suffering with an oblique fracture of the radius, he
rolled round the broken region long pads dipped in diluted plaster, upon
which he applied splints, also plastered, and kept in place by bands of the
same nature. After two months the apparatus was removed, the patient
left loose in a spacious place ; he stood well on his foot, there was no de-
viation in the leg. A horse treated the same way returned to work after
three months, notwithstanding a slight deviation of the leg inwards.
MoUer recommended a plastered bandage from the knee to the olecranon.'
Although serious, the prognosis of radial fracture is not necessarily fatal.
Lafore and Lafosse have obtained the recovery of an oblique fracture of
the radius, involving the radio-carpal joint.
If the fracture is open, fenestrated bandages permit the attendance and
care' of the wound, which at the same time they immobilize. Bringard
has cured a mare suffering with an open fracture of the radius, with
arthritis of the knee. The bandage being applied with mixture of Piau,
the articular lesions were treated with ordinary means (sublimate 2 p.
1000, nitrate of silver, segyptiacum.)
In small animals, complications must not prevent the practitioner from
1 In a case of compound fracture of the radius in a two-year-old filly, McLean per-
formed the amputation and the animal recovered. â€” Amer. Vet. Review, Vol. 12, p.
In the case of Adair, the mare, fifteen years old, was pregnant by a very valuable fast
stallion. She had sustained a compound fracture of the left forearm, the bone pro-
"truding through the side. The leg was amputated and the mare recovered, and gave
Siirth some two months after to a colt. â€” Am. Vet. Rev., Vol. 11, p. 547.
440 VETERINARY SURGICAL THERAPEUTICS.
attempting the treatment. By immovable dressings and antiseptic wash-
ings, Degive has obtained the recovery of an open fracture of the fore-
arm, compUcated with large contused wound, and complete periosteal
denudation of the broken fragments. In such cases, tepid antiseptic baths
â€¢are very advantageous. (See Open Fractures^
In young dogs, one meets sometimes with fractures of the inferior
epiphysis of the radius, badly united. It is generally possible to break up
again, with the hand, the defective callus. Or, again, the fractured centre
might be exposed, the callus broken, and the fragments replaced in their
proper straight line, followed by a new dressing.
IV. â€” Cubitus.
In horses, the cubitus is united to the radius in the greatest part of its
extent, except at its superior extremity, above the elbow joint which
forms the olecranon. Fractures of this bone frequently occur on a level
â– with the radio-cubital arch, but they may also take place between the
beak of the olecranon and the superior extremity of the radius ; they are
transversal or longitudinal.
When longitudinal or existing at the radio-cubital arch, the pieces of
"bone are kept in contact by the fibrous apparatus which surrounds
them. In the observations of Mercurin, Gombault, Watrin and Viard,
no elevation of the olecranon is mentioned. In the case of Mercurin,
Avhere it was drawn slightly inwards, no contentive bandage was applied ;
the animal was only placed in slings, and recovered completely. Per-
naud only used emollient lotions ; consolidation took place, but after
several months the horse was still quite lame. Gombault applied a some-
what complicated bandage. In his Observation IL, he used seven splints
secured by bands and a mixture of black pitch and rosin ; recovery was
perfect. A seven-year-old horse (Obs. III.) and a four months colt
(Obs. IV.) recovered without lameness remaining. Watrin and Viard
resorted to a bandage with splints, stucked with dextrine and securing
the elbow, fore-arm and knee. Delwart is sure that fracture of the ole-
cranon recovers radically in the majority of cases and advises the following
treatment : when, by extension of the leg, one has succeeded in reducing
the fracture by carrying the foot backwards, a quite thick pad of oakum
is applied on the inside of the elbow, to support the olecranon on the
inside and push it outwards ; this pad, which has been impregnated with
resinous mixture, is held in place with immovable bandage described for
fractures of the scapula and humerus. During treatment, the animal may
remain free, lie down and get up at will, without any inconvenience.'