252 OPERATIONS ON BONES. 



terstitial bemorrhagt^ which naturally follows the laceration of the 

 blood vessels of the region involved. If the fracture is at the neck 

 of the bone the muscles of that region (the gluteal) are firmly con- 

 tracted and the leg seems to be shortened in consequence. Loco- 

 motion is impossible. Crepitation may in some cases be discerned 

 by rectal examination, with one hand resting over the coxo femoral 

 articulation. Fractures of the tuberosities of the upper end of 

 the bone, the great trochanter, may be identihed by the deform- 

 ity, the swelling, the impossibility of rotation, and the dragging 

 of the leg in walking.- Fractui-e of the body is always accompanied 

 by displacement, and as a consequence a shortening of the leg, 

 which is carried forward. The lameness is excessive, the foot 

 being moved, both when raising it from the ground and when 

 setting it down, very timidly and cautiously. The manipulations 

 for the discovery of crepitation always cause much pain. Lesions 

 of the lower end of the bone are more difficult to diagnosticate 

 with certainty, though the manifestation of pain while making 

 heavy pressure upon the condyles will be so marked that only 

 crepitation will be needed to turn a suspicion into a certainty. 



The question as to treatment in fractures of this description 

 resolves itself into the query whether any treatment can be sug- 

 gested that can avail anything practically as a curative measure, 

 whether, upon the hypothesis of reduction as an accomplished fact, 

 any permanent or efficient device as a means of retention is within 

 the scope of human ingenuity. If the reduction were successfully 

 performed would it be possible to keep the parts in place by any 

 known means at our disposal? At the best the most favorable 

 resvdt that could be anticipated would be a reunion of the fragments, 

 with a considerable shortening of the bone, and a helpless, limp- 

 ing, crippled animal to remind us that for human achievement 

 there is a "thus far, and no farther." 



In small animals, however, attempts at treatment are justifiable, 

 and we are convinced that in many cases of difficulty in the appli- 

 cation of si^lints and bandages a patient may be placed in a con- 

 dition of undisturbed quiet and left to the processes of nature for 

 "treatment" as safely and with as good an assurance of a favorable 

 result as if he had been subjected to the most heroic secundurn 

 artem doctoring known to science. As a case in point, we may 

 mention the case of a pregnant bitch which suffered a fracture of 

 the upper end of the femur by being run over by a light wagon. 



