FRACTURES OF THE CERVICAL VERTEBRA. 391 



sinus, which seldom heals within a reasonable time. To prevent 

 such complications the wound must be carefully cleansed, con- 

 tinuously irrigated, and well drained. 



II.— FRACTURES OF THE CERVICAL VERTEBRA. 



The above fractures are not uncommon in horses. Fractures 

 of the atlas and of the other vertebrae of the neck occur, sometimes 

 singly and sometimes together. The usual cause is falling, as in hunt- 

 ing or steeplechasing — or in being driven over. Riding-horses in 

 violently bucking or falling over backwards not infrequently fracture 

 a cervical vertebra, usually the third or fourth. In bucking or 

 leaping, if the fore-limbs are not rapidly extended, the animal 

 comes to the ground on its mouth, and thus falling, even on 

 soft ground, may fracture the third or fourth vertebra. 

 Hertwig states having seen fracture of the odontoid process of 

 the second cervical under these conditions, but such fractures are 

 rare. Vertebral fractures are seldom produced by kicks, or thrusts 

 with the carriage pole. Cattle cause them by violently tilting at 

 each other. In small animals they result from blows with heavy 

 sticks or attempts to crawl through narrow openings in which they 

 become fixed and struggle to get free. 



Symptoms. The immediate effects of cervical fracture depend 

 on its extent and the degree of injury, if any, sustained by the spinal 

 cord. Partial fracture (oblique or transverse processes) may exhibit 

 only local symptoms, swelling, stiffness, etc. In horses fracture of 

 the 2nd, 3rd or 4th vertebra may be followed by instant death from 

 implication of the phrenic nerves ; but in fracture of the first, or 

 last two cervical vertebrae, the animals may live for some time. 

 Fractures of the last two are followed by paralysis of the muscles 

 of the shoulder, while fractures of the oblique processes produce 

 torticollis. 



A riding-horse, injured by falling, was ridden for some miles, but died 

 four days later, and post-mortem revealed fracture of the sixth cervical. 

 Scharfenberg described the following cases : — A horse, after running against 

 a door, fell, rose again, and worked for three hours. Next day paralysis 

 set in, death occurred on the third day, and post-mortem showed the body 

 of the second cervical vertebra broken completely across. A horse after 

 falling on the racecourse was ridden some four or five miles further. Signs 

 of paralysis then appeared, and two hours after the fall the horse died. 

 The autopsy showed a transverse fracture of the body of the fourth cervical 

 vertebra. A horse, examined after death by Rabe, had fractured the 

 first cervical on August 21st by falling, carried its head awry, showed 

 swelling in the neighbourhood of the atlas, and threatened to fall 



