Fractures of the Trachea. 169 



FRACTURES AND RUPTURES OF THE TRACHEA. 



Fractures are rather common in horses from striking the tra- 

 chea forcibly on the pole, shaft or in two-wheeled carts on the 

 tailboard of the next cart in front. They are especially common 

 in Scotland from the last cause, one man, driving two horses and 

 carts, the second closely following the first, suddenly stops the 

 first going down hill, and the second horse is driven by the im- 

 petus of its vehicle against the backboard of the first. Similar 

 injuries have come from falling on the margin of the manger 

 (Blaise), from bites (Bournay), kicks (Iviquet), and from pull- 

 ing on a halter tied around the neck (Reynal). 



The common seat of fracture is in the center of the ring, in 

 the median line in front, and as a fibrous joint forms at this 

 point, the circular outline of the ring is broken, the two detached 

 halves of the broken ring come together at an acute angle, and 

 by the contraction of the trachealis muscle above, the two sides 

 are drawn together and form a long narrow ellipse with its long 

 diameter supero-inferiorly. The resulting narrowing of the tube 

 and the obstruction to the current of air is often extreme. 



Laceration of the trachea by a staff, unskillfuUy used to 

 relieve choking in an ox, is recorded by Ugheli, and laceration 

 of the windpipe of a goat by the teeth of a shepherd dog by 

 Rinquet. 



Symptoms. Immediately after the injury there is more or less 

 effusion of blood which appears as a local swelling and perhaps 

 as a sanguineous discharge from the nose. Emphysema of the 

 connective tissue around the wound is often present and may 

 extend to the surrounding tissues so as to cause extreme dysp- 

 noea, and to crepitate on manipulation. This may be followed 

 by abscess or local infection. The flattening of the broken ring 

 from side to side and the prominent sharp angle of the line of 

 union in front are diagnostic. In early and late stages alike the 

 current of air is interrupted and a blowing or stertorous sound 

 (roaring) is heard in accelerated or forced respiration. The ex- 

 cess of blood and exudate pressing on the vagus or recurrent 

 nerve may cause extreme paralysis of the larynx with loud roar- 

 ing or dyspncea, and this may continue by reason of the organ- 

 ization and contraction of the exudate. 



