FRACTURES. 225 



angle it will be siifficient in order to effect the reduction to press 

 upon the summit or ajiex of the angle until its disai^ijearance in- 

 dicates that the parts have been brought into coaptation. This 

 method is often practiced in the treatment of a fractured rib. In 

 a longitudinal fracture, or when the fragments are pressed together 

 by the contraction of the muscles to which they give insertion 

 until they so overlap as to correspond by certain points of their 

 circumference, the reduction is to be accomplished by effecting 

 the movements of extension, counter-extension, and coaptation. 

 Extension is accomphshed by making traction uj^on the lower por- 

 tion of the limb. Counter-extension consists in firmly holding or 

 confining the upper or body portion in such a manner that it 

 shall not be affected by the traction ai^i^lied to the lower; in sim- 

 pler language, holding it motionless against the force exercised in 

 the extension. In other words, the oj^erator, grasping the limb 

 below the fractiu'e, draws it down or away from the trunk, while 

 he seeks, not to draw away, but simply to hold still the upper por- 

 tion until the broken ends of bone are brought to their natural 

 relative positions when the coaptation, which is thus affected, has 

 only to be made permanent by the proper dressings to perfect the 

 reduction. 



In treating fractures in small animals the strength of the hand ' 

 is usually sufficient for the required manipulations. In the fracture 

 of a forearm of a dog, for example, while the uj^per segment is 

 firmly held by one hand, the lower may be grasped by the other 

 and the bone itself made to serve the purpose of a lever to brin<>' 

 about the desired coaptation. In such a case that is sufficient to 

 overcome the muscular contraction and correct the overlapping or 

 other malposition of the bones. If, however, the resistance can 

 not be overcome in this mode, the upper segment may be committed 

 to an assistant for the management of the counter extension, 

 leaving to the operator the free use of both hands for the further 

 manipulation of the case. 



But if the reduction of fractures in small animals is an easy 

 task it is far from being so when a large animal is the patient, 

 whose muscular force is largely greater than that of several men 

 combined. In such a case resort must be had not only to superior 

 numbers for the necessary force, but in many cases to mechanical 

 aids. A reference to the mode of proceeding in a case of fracture 

 with displacement of the forearm of a horse will illustrate the 



