258 HEALTH AND DISEASE 



inclined towards the sound side. In some fractures, especially those 

 involving the acetabulum or hip-joint, pain is expressed by a more or less 

 audible grunt, by spasmodic twitching of the muscles, and an expression of 

 anxiety and fear. Where the round ligament (fig. 358) is in part or wholly 

 detached from its connection with the cup, the limb ceases to be altogether 

 under muscular control. In any attempt to move it, either the foot goes 

 beyond or falls short of the point it is intended to reach. In one step 

 it is thrown outwards, while in the next it may incline inwards, and the 

 movement of the limb generally is limp. 



The diagnostic symptom in this, as in all other fractures, is the presence 

 of a true crepitus or impression which rubbing of the broken pieces together 

 conveys to the hand or the ear. 



This may be at once evident on manipulation, or auscultation, or only 

 detected after much careful manoeuvring of the limb of the animal, or 

 it may be altogether absent. In order to bring it about, an assistant 

 should be instructed to move the leg carefully in various directions, 

 inwards, outwards, backwards, and forwards, and to rotate it gently first 

 in one direction and then in the other. During this time the hand or the 

 ear of the examiner should be applied to the point of the ilium, and moved 

 backward from place to place to the point of the buttock, the mind being 

 at the same time concentrated upon it. The hand should then be passed 

 into the rectum and brought into contact with every available part of the 

 pelvis. Any crepitus occasioned by the movement will then be felt, and 

 any swelling or displacement of the broken pieces at once recognized. 

 Crepitus may sometimes be induced and recognized by pushing the animal 

 over from one side to the other, while still keeping the hand on the quarter 

 or in the rectum. The absence of crepitus and severe lameness does not 

 always indicate the absence of fracture, but may be the result of no 

 displacement of the broken bone having taken place. 



In these cases of doubt the examination should be repeated day by day 

 for several days, during which the patient must be kept perfectly quiet. 



Treatment. The broken pelvis does not lend itself to those measures 

 of mechanical restraint which are employed so successfully in dealing with 

 some of the bones of the extremities, and we are therefore restricted in our 

 endeavours to effect reparation to the device of slinging and maintaining 

 as nearly as possible an upright posture, thereby avoiding those disturbing 

 efforts involved in lying down and rising again, movements which are 

 sometimes attended with most disastrous results. 



Whether treatment is likely to be attended with success or not is a 

 question which the examiner must answer for himself after having made a 

 searching examination. 



