General treatment of fractures.—When a fracture occurs, the advisability of attempting treatment must first be determined. If the animal is young, valuable, and of reasonably quiet temperament, and the fracture is not too great in extent, the chances of recovery are fair. On the other hand, if the animal should be of little value, irritable, advanced in years, and the fracture is a serious compound or comminuted one, the wiser course would generally be to put the creature out of its misery.

Having determined to attempt treatment, no time should be lost in restoring the parts as nearly as possible to their natural position and retaining them there. If the ends of the bones have been drawn one past the other, they should be drawn out by firm and continuous tension, until they again assume the position in which they were before the accident. All this can better be done before the swelling (which is sure to result) takes place. If the swelling has occurred before the injury is noticed, do not attempt to treat it, but proceed at once to treat the fracture as though the swelling were not present, for no step can be taken toward recovery until the ends of the bone have been restored to their proper position. When that is done and proper appliances have been used to prevent them from being again misplaced, the swelling, which is the result of irritation, will be relieved. In selecting the appliances to be used in the treatment of fracture the judgment and ingenuity of the operator are of much importance. Splints, made of wood shaped to fit the limb and padded with soft material where they come in contact with bony prominences, and held in position by means of bandages, are the oldest method, and with some are still most popular. The fracture pads used in human surgery, and for sale in surgical depots, are very convenient. After being dipped in water they may be molded to fit the limb and be retained by means of bandages. Heavy sole leather is also used after being soaked in warm water and molded to the shape of the limb and holes cut in it to fit over any sharp irregularities in the natural shape of the bones. Gutta-percha sheets are also used and answer well. They are prepared and used in the same way as the leather.

Another and perhaps the simplest of all methods is the application of a plaster-of-Paris bandage, which is made as follows: Strips of thin cheesecloth 3 inches wide and 8 or 9 feet long are laid flat on a board and on them is spread a layer of plaster of Paris about one-eighth of an inch thick; then, starting at one end, roll carefully so as to gather the plaster in between the layers of the bandage. It is of course important that the cloth be thin and the plaster of Paris fresh and active. After preparing four or five of such bandages the operator is ready to dress the fracture, which, after the parts have been brought into position, should be done by covering all that part of the limb to which the plaster-of-Paris bandage is to be applied with a single layer of the dry bandage, letting it extend both above and below the part to which the plaster bandage is to be applied and including under the folds of the dry bandage at each end a layer of absorbent cotton, which is intended to form a pad to prevent the ends of the plaster bandage from chafing the skin beneath. When this is done one of the plaster bandages should be placed in a vessel of water and allowed to remain till the air bubbles have ceased to rise from it, which will generally indicate that it is soaked through. Then, taking it in the hand, wind it carefully around and around the limb, unrolling the bandage as it is wound around the limb, occasionally smoothing down the plaster of Paris. Should it form roughly or in ridges the hand may be dipped in water to impart increased moisture to it. When about finished with one bandage, place another one in the water, so that the winding operation may be continued without delay. The bandages should be applied till the cast is from one-half to three-quarters of an inch thick, then gently restrain the animal for one-half or three-quarters of an hour till the plaster is hardened. Any of the appliances used should be so manipulated as to prevent absolutely any motion of the detached parts. If the fracture is near a joint, it is generally best to include the joint in the appliance. The part of the limb below the bandage should be carefully and firmly wrapped with an ordinary cotton bandage all the way from the plaster bandage down to the hoof. This last bandage will tend to prevent swelling, which is liable to occur, the result of the dependent position in which the animal is forced by nature to keep the injured limb.

When plaster-of-Paris bandages are applied to a compound fracture the injured part may be previously dressed with a small, thick pad of cotton immediately over the wound. In applying the bandage the operator may with a little care so arrange it as to keep the folds of the bandages off the cotton, or have only a thin layer over it, which may be easily cut out and the cotton removed, leaving a convenient opening through which to dress the wound without removing the bandage. The ends of the bandage or other appliance should be carefully watched to see that the skin does not become chafed, particularly at the lower end. If the bandage should become weak or broken at any part, it may be strengthened without removal by applying other bandages immediately over it. If swelling has taken place before the bandage has been applied, there is liable to be some loosening as it disappears, and even without the swelling there may be a tendency of the bandage to slide downward. This may be overcome by fastening it to a suspender attached to a surcingle or passed over the body and attached to the opposite leg. If the looseness can not be overcome in this way, the space may be filled by pouring in a thin paste of plaster of Paris. A better method, however, is to remove the bandage and apply another. Owing to the hardness of the bandage it will be removed with some difficulty. A deep groove should be cut down completely through it on the opposite sides. This may be done with a chisel and a small hammer if the bandage is carefully held by an assistant so that the concussion of the blows is not transmitted to the injured bones. The patient should have a roomy stall, and should be tied by the head to prevent any attempts to move around. In some cases slings have been used. Ordinarily, however, they are not satisfactory in cattle practice, and if applied should be for only a few days at a time, and with a view to lessen the animal's disposition to lie down, rather than to prevent it. When they are used continuously the pressure on the abdomen may interfere with digestion and the general health of the animal.

Modes of union.—The animal should be kept as quiet as possible and given such feed as will have a tendency to keep the bowels slightly relaxed. The success of the operation depends chiefly on the skill of the operator, but not alone in the selection and use of the appliances, for as much attention must be given to subsequent management. The patients are restless, and a single awkward motion may undo the work of weeks so far as the union of the parts of the bone is concerned. Union takes place after the same process and, if the conditions are favorable, with greater rapidity than in the human being. The injury that caused the fracture is almost sure to have extended to some of the adjacent tissues, and even though the fracture may be of the simplest type there is almost sure to be considerable hemorrhage around the ends of the broken bone. This, however, is unimportant if the skin remains intact, unless a very large vessel should be injured, or the fracture should open some of the important cavities of the body, in which case a fatal hemorrhage may result. If, on the other hand, the fracture is compound the external opening furnishes a fertile field for the lodgment of disease-producing germs.

Unless great care is taken in such cases, a suppurative process is liable to be established which will seriously interfere with, if not entirely arrest, the process of union between the bones; or it may become so serious as to endanger the general health of the animal and even be attended with fatal results. This last danger is greater if the injury has occurred to the bones of the arm or thigh. In such cases, owing to the dense covering of fascia which ensheathes the muscular covering pus is liable to be imprisoned, and, burrowing downward, saturate the whole structure, not only endangering the limb, but, by absorption, may set up blood poisoning and seriously interfere with the general health of the patient, even to causing death. In order so far as possible to prevent such an unfortunate complication, the wound should be carefully cleansed with a mild solution of carbolic acid, then dusted over with iodoform before the bandages are applied, and cleansed and dressed daily in the same way. After dressing, always cover with absorbent cotton. In the early process of union an exudation of lymph takes place, which is at first fluid, gradually becoming thicker and firmer till it forms a callus, known as the external or ensheathing callus, in the shape of a ring or ferrule surrounding the detached portions of the bone. It occasionally happens that this callus forms only at the ends of the bones, filling the spaces that exist between them, when it is known as the intermediate callus. The process of union may be divided into five stages. In the first stage, including the first eight days, the detached portions of the bone and the sharp projections that are not sufficiently nourished are absorbed; the blood which escaped into the surrounding tissues, the result of the injury, is gradually absorbed, and the effused lymph, which is ultimately to constitute the temporary cartilage, takes it place. In the second stage, from the tenth to the twentieth day, the tumor or callus is formed and fibrocartilage is developed inside and around the exposed end of the bone. In the third stage, extending from the twentieth to the fortieth or fiftieth day, according to the age and strength of the animal, the fibrocartilaginous structure undergoes a change and is gradually converted into bone, forming a ferrule on the outside and a plug on the inside, which serve to hold the part in position. In the fourth stage, extending to about the sixth month, the whole of the new structure is converted into bone. In the fifth stage, extending to the end of the first year, the callus is absorbed, being no longer necessary, and the connection between the cavities of the two bones is again established.

Common complications.—The process of union just described is healthy and normal. Diseased conditions may at any time supervene during the treatment and render the operation unsuccessful. In the case of compound fracture, the open wound communicating with the ends of the bones, a septic condition is liable to arise which may become so serious as to endanger the animal's life and bring about conditions which in human surgery would indicate amputation. Although that operation is not a general one in veterinary practice, there is no reason why it should not be attempted as a last resort, particularly if the animal is valuable or is one whose existence is necessary in order to perpetuate some valuable strain. Even in the simplest form of fracture, if the splints or bandages are improperly applied and the fractured bone left so loosely guarded that the broken ends move one upon another, the formation of the calluses previously described is liable to be interfered with, and in place of a strong, rigid, and healthy union a formation of elastic cartilage is the result. This false structure unites the broken ends of the bones in such way that they move one upon another, depriving the bone of its stability and usefulness. When once the healthy process of union is interrupted in the manner just described, it is again established with great difficulty. It no longer does any good to continue the restraining power; in fact, the change of the temporary cartilage into bone is more liable to be reestablished if the parts move violently upon each other for a short time so as to set up and renew the process of inflammation. Then if the restraint is again applied there is some chance of union. In order so far as possible to avoid this danger, care should be taken to see that the bandage fits closely and that it is kept on till there is no longer any danger but that a perfect union has taken place. It is impossible to say at just what time the splints or bandages can safely be removed. In a young and healthy animal of quiet temperament, if the parts have been firmly held in position throughout the whole time, from 30 to 40 days may be regarded as reasonably safe. Under more unfavorable conditions as to age, vitality, and restraint, the period would better be extended to 60 days, if the general condition of the animal is such as to permit of so long a continuance. After the appliance has been removed the animal should be allowed to stand quiet for a few days, then be given very gentle exercise, gradually increased for a week or 10 days, by which time the patient will be so far recovered as to be placed in pasture. It should, however, be alone for a time, so as not to take any chance of injury from fighting or other accidents that association with other animals might involve.

SPECIAL FRACTURES.

Fracture of the horns.—Of the special fractures liable to occur, that of the horn is perhaps the most common. It is always the result of violent mechanical means, such as blows, injury occurring while fighting, or from the animal getting its head locked in some manner while feeding from a rack. When it occurs there are two ways in which the injury may affect the animal. First and most common, the horny crust is liable to be stripped from the bony projection which it covers. Second, the crust and bone may both be broken or bent down, the fracture occurring in that case at the root of the horn and involving part of the bones of the head in the immediate vicinity. In the first case, if the horny covering is knocked off, little attention is necessary. The animal may be relieved from suffering if the stump is smeared with pine tar and wrapped in cloth. If the core is much lacerated, perhaps it would be better to amputate. The necessity for such operation must be determined by the condition of the injury, influenced to some extent by the owner's ideas on the subject. When the operation is performed, it should be done with a sharp, fine-toothed saw, and by sawing the horn off close enough to include a little of the skin and hair around its base. The practice of dehorning has grown popular in many parts of the country. It is a simple operation, and, although attended with some immediate suffering, does not produce serious constitutional disturbance. The advisability of performing the operation on all cattle is a question of expediency and must be justified by the expectation of benefit on the part of the feeder. If the horn should be broken so that the core and crust are bent out of shape without the detachment of one from the other, it may be restored to its normal position and retained there by means of a splint made to fit across the back of the head, so as to be laced to both horns, the sound horn serving to hold the broken one in position. Such a splint may be fastened on by means of either a wire or cord and allowed to remain six weeks or two months.

If both the horn and core have been broken off, bleeding is usually severe and should be checked by astringents, such as alum, or by pressure. After the hemorrhage has ceased the exposed portion of the fracture should be covered with pine tar, with or without a bandage. An imperfect growth of horn will in due time cover the exposed bone.