340 DISEASES OP THE HORSE. 



the posterior, while the front is largely covered and defended by the 

 shoulder. A single rib may be the seat of fracture, or a number may 

 be involved, and there may be injuries on both sides of the chest at the 

 same time. It may take place lengthwise, in any part of the bone, 

 though the middle, being the most exposed, is the most frequently 

 hurt. Incomplete fractures are usually lengthwise, involving a por- 

 tion only of the thickness of one or other of the surfaces. The com- 

 plete kind may be either transverse or oblique, and are most com- 

 monly denticulated. The fracture may be comminuted, and a single 

 bone may show one of the complete and one of the incomplete kind at 

 different points. The extent of surface presented by the thoracic 

 region, with its complete exposure at all points, explains the liability 

 of the ribs to suffer from all the forms of external violence. 



SymptoTns. —In many instances fractures, especially the incom- 

 plete variety, of these bones continue undiscovered, without displace- 

 ment, though the evidences of local pain, a certain amount of swell- 

 ing, and a degree of disturbance of the respiration, if noticed during 

 the examination of a patient, may suggest a suspicion of their exist- 

 ence. Abnormal mobility and crepitation are difficult of detection, 

 even when present, and they are not always present. When there is 

 displacement the deformity which it occasions will betray the fact, 

 and when such an injury exists the surgeon, in view of possible and 

 probable complications of thoracic trouble, of course will become 

 vigilant and prepare himself for an encounter with a case of trau- 

 matic pleuritis or pneumonia. Fatal injuries of the heart are re- 

 corded. Subcutaneous emphysema is a common accompaniment of 

 broken ribs, and I recall the death, from this cause, of a patient of 

 my own which had suffered a fracture of two ribs in the region of the 

 withers, under the cartilages of the shoulder, and of which the diag- 

 nosis 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 so solid and complete as in other fractures, the callus 

 being usually imperfect and of a fibrous character, with an amphiar- 

 throsis formation. Still, complications occur which may impart 

 gravity to the prognosis. 



Treatment. — Fractures with but a slight or no displacement need 

 no reduction. All that is necessary is a simple application of a blis- 

 tering 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 immobilization of the parts. At times, how- 

 ever, a better effect is obtained by the application of a bandage 

 placed firmly around the chest, although, while this limits the mo- 

 tion of the ribs, it is liable to render the respiration more labored. 



If there is displacement, with much accompanying pain and evi- 

 dent irritation of the lungs, the fracture must be reduced without 



