974 DISEASES OF THE LEG. 



the last doubts of fracture ; in such case traces of the external injury 

 are generally apparent. 



Fissuring sometimes, though not invariably, produces lameness, 

 both when weight is placed on the limb and when it is carried. 

 Starting from the injured point, which may be depressed, the line 

 of fissure in the bone may be mapped out by the existence of pain 

 over it. Fissures in the subcutaneous regions of the tibia may 

 sometimes be diagnosed with certainty, otherwise they can only be 

 guessed at, for this linear distribution of pain, which is the sole reliable 

 symptom, cannot be detected under the muscular tissue. In the 

 cases described in which there was no lameness, the fissure was 

 probably subperiosteal. Incomplete fractures and local injuries 

 are accompanied by more or less lameness, depending on the degree 

 of periostitis ; should the latter be slight, lameness is so little marked 

 that animals, even with incomplete fracture, may be kept at work 

 until complete fracture suddenly occurs. On the other hand, partial 

 fracture and local injury to the bone may often be at once recognised 

 provided the soft parts are not greatly swollen. From the uncertainty 

 which surrounds these cases, it is of the utmost importance, in every 

 painful lameness resulting from mechanical injury to the inner 

 surface of the tibia, to bear in mind the possibility of fissure or in- 

 complete fracture. Its existence is the more probable if lameness 

 be severe, and no marked periostitis or local pain can be discovered. 



Fractures of the malleoli of the lower end of the tibia, common 

 in man, are rare in animals, though on post-mortem examination 

 Leisering detected a case which had caused obstinate and incurable 

 lameness. The external malleolus was separated for a length of 

 1 ' 4 inch, and to a height of ' 6 inch. The anterior portion of the 

 middle protuberance was fractured. 



Course and prognosis. Although, in the horse, complete fracture 

 of the tibia is almost always incurable, because the patient is unable 

 continuously to stand on the other leg until the fracture unites, and 

 splints, &c, can only be applied to the lower portions, yet in oxen 

 recovery has been repeatedly seen. Recovery has also been seen 

 in young foals ; in some cases a splint was applied, but in others 

 no precaution was adopted. Rivolta describes a case in the ox in 

 which a splint was applied by the local blacksmith. After six to seven 

 weeks the animal walked sound. When the horse is valuable, and 

 not of an excitable disposition, treatment may be attempted, 

 especially if the seat of fracture be near the lower end of the tibia ; 

 in such cases recovery is possible. Foals and light-bred horses of 

 quiet temperament are better able to endure the continuous lying 



