It will be desirable, perhaps, to describe our usual method of reducing the greater part of the fractures which come under our notice.
- [The] humerus was fractured just above the elbow and close to the
joint. The limb was enclosed in adhesive plaster, and supported by a
firm bandage. The bones were beginning to unite, when, by some means
concerning which I could never satisfy myself, the tibia was broken a
little above the hock. Nothing could well be done with this second
fracture; but great care was taken with regard to the former. The lower
head of the humerus remained somewhat enlarged; but the lameness became
very slight, and in three weeks had nearly or quite disappeared. Nothing
was done to the second fracture; in fact, nothing more than a slight,
annular enlargement, surrounding the part, remained — a proof of the
renovating power of nature.
- A spaniel was run over by a light carriage. It was unable to put
the left hind leg to the ground, and at the upper tuberosity of the
ileum some crepitus could be distinguished. I subtracted six ounces of
blood, administered a physic-ball, and ordered the patient to be well
fomented with warm water several times during the night. On the
following day no wound could be discovered, but there was great
tenderness. I continued the fomentation. Two or three days afterwards
she was evidently easier. I then had the hair cut close, and covered the
loins and back with a pitch-plaster. At the expiration of six days the
plaster was getting somewhat loose, and was replaced by another with
which a very small quantity of powdered cantharides was mingled. At the
expiration of the fifth week she was quite well.
- [The] thigh-bone had been broken a fortnight. It was a compound
fracture: the divided edges of the bone protruded through the
integuments, and there was no disposition to unite. It is not in one
case in a hundred that an animal thus situated can be saved. We failed
in our efforts, and the dog was ultimately destroyed.
- The femur was broken near the hip. I saw it on the third day,
when much heat and swelling had taken place. I ordered the parts to be
frequently bathed with warm water. The heat and tenderness to a
considerable degree subsided, and the pitch-plaster was carefully
applied. At the expiration of a week the plaster began to be loosened. A
second one was applied, and when a fortnight longer had passed, a slight
degree of tenderness alone remained.
- [The] following account is characteristic of the bull terrier. The
radius had been broken, and was set, and the bones were decidedly
united, when the dog, in a moment of frantic rage, seized his own leg
and crushed some of the bones. They were once more united, but his wrist
bent under him in the form of a concave semicircle, as if some of the
ligaments of the joint had been ruptured in the moment of rage. It was
evident on the following day that it was impossible to control him, and
he was destroyed.
- [A] spaniel, three months old, became fractured half-way between the
wrist and the elbow. A surgeon bound it up, and it became swollen to
an enormous size, from the adhesive plaster that had been applied and
the manner of placing the splints. I removed the splints. On the
following morning I had the arm frequently fomented: a very indistinct
crepitus could be perceived at the point of the humerus: I applied
another plaster higher up, and including the elbow. The hair not having
been cut sufficiently close, the plaster was removed, applied much more
neatly and closely, and the original fracture was firmly bound together.
No crepitus was now to be perceived.
I saw no more of our patient for four days, when I found that he had fallen, and that the elbow on the other side was fractured within the capsular ligament. A very distinct crepitus could be felt, and the dog cried sadly when the joint was moved. I would have destroyed him, but he was a favourite with his master, and we tried what a few days more would produce. I enclosed the whole of the limb in a plaster of pitch, and bound it up without splints. Both the bandages remained on nearly a fortnight, when the fractures were found to be perfectly united, and the lameness in both legs gradually disappeared. - July 22, 1843. A spaniel was frightened with something on the
bed, and fell from it, and cried very much. The instep, or wrist, of the
right leg, before was evidently bowed, and there was considerable heat
and tenderness. It was well fomented on the two following days, and then
set, and adhesive plaster was tightly applied, and a splint bound over
that.
24th. The foot began to swell, and was evidently painful. The outer bandage was loosened a little, but the inner bandage was not touched.
Aug. 4. The bandage, that had not been meddled with for eleven days, now appeared to give him some pain. For the last two days he has been gently licking and gnawing it. The splints were removed; but the adhesive plaster appearing even and firm, was suffered to remain.
26th. Everything appeared to be going on well, when he again leaped from his bed. The wrist was much more bowed, and was tender and hot. Simple lint and a firm calico bandage were had recourse to.
27th. He is unable to put his foot to the ground, and the joint is certainly enlarging. An adhesive plaster, made by a Frenchman, was applied at the owner's request, over which was placed a splint. The dog soon began to gnaw the plaster, which formed a sticky but not very adhesive mass. Before night the pain appeared to be very great, and the dog cried excessively. I was sent for. We well fomented the leg, and then returned to our former treatment. There was evidently a great deal of pain, but it gradually passed over, and a slight degree of lameness alone remained.
I
great pleasure in adding the following accounts of the successful treatment of fractures in dogs by Mr. Percivall:
"Hopeless as cases of fracture in horses generally are, from the difficulty experienced in managing the patient, they are by no means to be so regarded in dogs. I have in several instances seen dogs recover, and with very good use of the parts, if not perfect restoration of them, when the accidents have been considered, at the time they took place, of a nature so irremediable as to render it advisable to destroy the animals.
"May 4, 1839. A [valuable] Irish spaniel fell from a high wall, and fractured his off shoulder. On examination, I found the os humeri fractured about an inch above its radial extremity, causing the limb to drop pendulously from the side, and depriving the animal of all use of it. The arm, by which I mean the fore arm, was movable in any direction upon the shoulder, and there was distinct crepitus: in a word, the nature of the accident was too plain to admit of doubt; nor was there any splinter or loose piece of bone discoverable. I directed that the animal might be laid flat upon his sound side in a hamper, or covered basket or box, of sufficient dimensions, but not large enough to admit of his moving about; to have his hind legs fettered, his mouth muzzled, and his injured parts covered with a linen cloth wetted with a spirit lotion.
May 5. The parts are tumefied, but not more, nor even so much as one night have expected. Continue the lotion.
6th. At my request, Mr. Youatt was called in to give his opinion as to the probability of effecting a cure. He thought from the inconvenient situation of the fracture, that the chances of success were doubtful; and recommended that a plaster, composed of thick sheep-skin and pitch, cut to the shape of the parts, should be applied, extending from the upper part of the shoulder down upon the arm, and reaching to the knee; and that the whole should be enveloped in well-applied bandages, one of them being carried over the shoulders and brought round between the fore legs, to support the limb, and aid in retaining the fractured ends in apposition. Prior to the application of the pitch plaster the hair was closely shorn off. Thus bound up, the dog was replaced in his hamper, and had some aperient medicine given to him.
8th. The medicine has operated; and he appears going on well, his appetite continuing unimpaired.
10th. He growls when I open the basket to look at him. On examining him (while his keeper had hold of him), I found the plaster loosening from its adhesion; I took it off altogether, and applied a fresh one, composed of the stopping composition I use for horses' feet.
June 7. Up to this time everything appears to have been going on properly. The fracture feels as if it were completely united, and, as the plaster continues to adhere firmly, I thought the bandages enveloping it, as they were often getting loose, might now he dispensed with, and that the dog might with benefit be chained to a kennel, instead of being so closely confined as he has been. In moving, he does not attempt to use the fractured limb, but hops along upon the three other legs.
July. He has acquired pretty good use of the limb. Being now at liberty, he runs about a good deal; halting, from there being some shortness of the limb, but not so much as to prevent him being serviceable, as a slow hunter, in the sporting-field.
"[About] a twelvemonth ago," continues Mr. Percivall, "I was consulted concerning a blood-hound of great size and beauty, and of the cost of £50, that had been a cripple in one of his hind limbs for some considerable time past, owing, it was said or thought, to having received some injury. After a very careful handling, and examination of the parts about the hips, the places where he expressed pain, I came to the conclusion that there had been, and still existed, some fracture of the ischial portion of the pelvis, but precisely where, or of what nature, I could not determine; and all the treatment I could recommend was, that the animal should be shut up within a basket or box of some, sort, of dimensions only sufficient to enable him to lie at ease, and that he be kept there for at least six months, without being taken out, save for the purpose of having his bed cleansed or renewed. His owner had previously made up his mind to have him destroyed; understanding, however, from me, that there still remained a chance of his recovery, he ordered his groom to procure a proper basket, and see that the dog's confinement was such as I had prescribed. The man asked me to allow him to have his kennel, which, being no larger than was requisite for him, I did not object to; and to this he had an iron lattice-door made, converting it into a sort of wild beast cage. After two months' confinement, I had him let out for a short run, and perceived evident amendment. I believe altogether that he was imprisoned five months, and then was found so much improved that I had him chained to his kennel for the remaining month, and this, I believe, was continued for another month. The issue was the complete recovery of the animal, very much to the gratification and joy of his master, by whom he is regarded as a kind of unique or unobtainable production.
"The fractures of dogs and other animals must, of course, be treated in accordance with all the circumstances of their cases; but I have always considered it a most essential part of their treatment that such portable patients as dogs and cats, &c., should be placed and kept in a state of confinement, where they either could not, or were not likely to, use or move the fractured parts; and, moreover, I have thought that failure, where it has resulted after such treatment, has arisen from its not having been sufficiently long persisted in."
the opinion of Professor Simonds, when there is fracture of the bones of the extremities, a starch bandage is the best that can be employed. If applied wet, it adapts itself to the irregularities of the limbs; and if allowed to remain on twelve hours undisturbed, it forms a complete case for the part, and affords more equal support than anything else that can possibly be used.
following case was one of considerable interest. It came under the care of Professor Simonds. Two gentlemen were playing at quoits, and the dog of one of them was struck on the head by a quoit, and supposed to be killed. His owner took him up, and found that he was not dead, although dreadfully injured. It being near the Thames, his owner took him to the edge of the river, and dashed some water over him, and he rallied a little. Professor Simonds detected a fracture of the skull, with pressure on the brain, arising from a portion of depressed bone. The dog was perfectly unconscious, frequently moaning, quite incapable of standing, and continually turning round upon his belly, his straw, or his bed. It was a case of coma; he took no food, and the pulsation at the heart was very indistinct.