Reduction of femoral fracture in the horse is practically impossible, and retaining the broken bones in coaptation is not possible by means of mechanical appliances.
There are decided disadvantages to the filling up of the tissues with fluid; healing is delayed; relations are distorted and coaptation of the edges is difficult.
If clots have gathered in a wound, they must be removed, as their presence will prevent accurate coaptation of the edges.
Relaxation stitches should be removed in four or five days, and stitches of coaptation in from seven to ten days.
When there is any difficulty in bringing the edges of the wound into apposition, a few interrupted relaxation stitches may be introduced wide of the margins, to take the strain off the coaptation stitches.
The object of this is to ensure correct coaptation of the flaps, and to avoid any risk of disfigurement.
Shows the skin incision, with the transverse scratches made to ensure correct coaptation of the flaps.
They cause a diminution in the cavity in which they are found, thus narrowing the orifice through which the blood passes, or preventing a proper coaptation of the valves, which may produce most serious valvular disease.
The difficulty of reduction and coaptation in this accident, and the probability of bony deposits, as of ringbones, resulting in lameness, are circumstances which tend to discourage a favorable prognosis.
A simple fracture occurring in a bone where the ends can be firmly secured in coaptation presents the most favorable condition for successful treatment.
It is better to endeavor to obtain coaptation by means of bandages, plasters, or collodion.
When coaptationhas been effected it must be retained by the external application of an adhesive mixture, with splints and bandages around the chest.
Rapid and great swelling takes place, if reduction and coaptation are not soon resorted to; the bloodvessels are torn more and more by the ends of the bone, and effusion of blood into the intermuscular cellular tissue is easy.
The twisted suture is best adapted for this purpose; more accurate coaptation being thereby obtained than by the interrupted form.
In all fractures, whether simple or compound, comminuted or complicated, if an attempt is to be made to save the limb, let reduction be immediate; coaptation and retention of the separated parts cannot be made too soon.
