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There is danger of infection resulting in simple carpal fractures and, needless to say, in a compound-comminuted fracture of the carpus, infection usually occurs and a fatal outcome is probable. When treatment is instituted, antiseptic precautions are taken in handling the compound fractures, and in any case immobilization of the parts is sought.
Immobilization of the broken parts of the bone is the object sought. This is attempted by practitioners who employ various methods, and each method has its advocates. Casts are used by some and serve very well in many cases; but because of their bulk and unyielding and rigid nature, they are not well adapted to use on fractures of bones proximal to the carpus and tarsus.
Needless to say, marked lameness and swelling of the fetlock soon take place. The condition is painful, and ordinarily, recovery is impossible. Treatment. Where treatment is attempted, immobilization as in luxation is in order. The patient's comfort is sought, and if the fractured parts can be kept in close proximity, their union may occur in time.
Perfect apposition of the broken ends of bone is easily effected and less difficulty is encountered in maintaining such relations in metacarpal fractures than in fractures of the radius. However, reduction and immobilization of this as in all fractures, must be done without delay.
For permanent immobilization of the phalanges in fracture, materials which might adapt themselves to the irregular contour of the member and at the same time contribute sufficient rigidity to the parts without doing injury to the soft structures, would constitute ideal means of treatment; but no such materials have yet been devised, and opinions are various as to the most efficient and practical method to employ.
In this manner one may make repeated examinations of the subject, and if slings are used and every other necessary precaution taken to promote comfort for the subject, no harm will result in delaying for several days the application of permanent immobilization bandages and splints or casts.
Jerome M. Schneck, clinical associate professor of psychiatry, State University of New York College of Medicine, is that hypnosis should be equated with states of immobilization on the basis of his observation that some subjects equate hypnosis with "death." He suggests this is comparable to the "death-feint" of animals to avoid danger.
As has been mentioned in the consideration of radial fractures, heavy leather is better suited for immobilization of these parts than a cast or other rigid splint materials. Mature animals may be expected to resist the immobilization of the hind legs because of the normal manner of flexion of the tarsal and stifle joints in unison.
The temperament of the animal must be considered in such cases, and if a lame horse is too active and playful when given his freedom, exercise must be restricted or prevented, as the case may require. In cases of strains of tendons, during the acute stage, immobilization of the affected parts is in order.
Because of immobilization of the stifle and hock joints in upward luxation, the subject can walk only by hopping on the sound leg and then the extremity is flexed, allowing the anterior portion of the fetlock to drag on the ground. Such cases may be styled momentary luxation, whether they are due to a weakened condition of the patellar ligaments or spasmodic contraction of the crural muscles.
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