256 



OPERATIONS ON BONES. 



bility, crej)itation, inability to sustain weight, and the leg is kept 

 off the ground by the flexion of the upper joint. 



No region of the body affords better facilities for the application 

 of treatment, and the prognosis is, on this account, usually favor- 

 able. We recall a case, however, which proved fatal, though under 

 exceptional circumstances. The patient was a valuable staUion of 

 highly nervous organization, with a com]30und fracture of one of 

 the cannon bones, and his unconquerable resistance to treatment, 

 excited by the intense j)ain of the wound, precluded aU chance of 

 recovery, and ultimately caused his death from nervous fever. 



The general form of treatment for these lesions will not differ 

 from that which has been already indicated for other fractures. 

 Eeduction, sometimes necessitating the casting of the patient; 

 coaptation, comparatively easy by reason of the subcutaneous sit- 

 uation of the bone ; retention, by means of splints and bandages 

 — appHed on both sides of the region, and reaching to the ground 

 as in fractures of the forearm — these are always indicated. We 

 have obtained excellent results by the use of a mold of thicF gutta 

 percha, composed of two sections and made to surround the entire 

 lo.ver part of the leg as in an inflexible case. 



Fracture of the first Phalanx. — The hinder extremity is more 

 liable than the fore to this injury. It is usually the result of a 



Fig. 280— Splint and Dressing 

 on Lower Part of Fore Leg. 



Fig. 281.— Bourgelat's Splint for Frac- 

 ture of the Cannon and Phalanges. 



