FUACTURES. 



239 



"Wlieu there is tlisplacemeut tlie deformity which it occasions will 

 betray the fact, and when such an injury exists the sm-geon will, 

 of course, become vigilant in view of jDossible and probable com- 

 phcations of thoracic trouble, and prepare himself for an encoun- 

 ter with a case of traumatic pleuritis or pneumonia. Fatal injur- 

 ies of the heart are recorded. Subcutaneous emphysema is a 

 common accompaniment of broken ribs, and we recall the death 

 from this cause of a patient of our ovm, which had suffered a frac- 

 ture of two ribs in the region of the withers under the cartilages 

 of the shoulder, and of which the diagnosis was made only after 

 the fatal ending of the case. 



These hurts are not often of a very serious character, though 

 the union is never as solid and complete as in other fractures, the 

 callus being usually imperfect and of a fibrous character, with an 

 amphiartkrosis formation. Still, comj)Hcations occur which may 

 impart gravity to the prognosis. 



Fractures with but a slight or no displacement need no reduc- 

 tion. All that is necessary is a simple application of a blistering 

 nature as a preventive of inflammation or for its subjugation when 

 present, and in order to excite an exudation which will tend to 

 aid in the support and immobHization of the parts. At times, 

 however, a better effect is obtained by the application of a band- 

 age placed firmly around the chest, although, while this limits the 

 motion of the ribs, it is aj)t to render the respiration more labored. 



If there is displacement with much accompanying pain and 

 evident irritation of the lungs, the fracture must be reduced with- 

 out delay. The means of effecting this vary according to whether 

 the displacement is outward or inward. In the first case the 

 bone may be straightened by pressure from without, while in the 

 second the end of the bone mvist be raised by a lever, for the in- 

 troduction of which a small incision through the skin and inter- 

 costal spaces wiU be necessary. When coaptation has been af- 

 fected it must be retained by the external apphcation of adhesive 

 mixture, with spUnts and bandages around the chest. 



Fractures of the hones of the pelvis wiU be considered under 

 their separate denominations, as those of the sacrum and the as 

 innominata, or the hip, which includes the subdivision of the 

 iUum, the pubes, and the ischium. 



The Sacrum. — Fractures of this bone are rarely met with 

 among solipeds. Among cattle, however, it is of common occur- 



