321 



of that side of the hip iu width, unite in indicating the existence of 

 the condition expressed by the term " hipped." But an incomplete 

 fracture, or one that is comi^lete without displacement, or even one 

 with displacement, often demands the closest scrutin^^ for its dis- 

 covery. The lameness may be well marked, and an animal may show 

 but little ai^pearance of it while walking, but upon being urged into a 

 trot will manifest it more and more, until presently he will cease to 

 use the crippled limb altogether, and perform his traveling entirely 

 on three legs. The acute character of the lameness will vary in 

 degree as the seat of the lesion approximates the acetabulum. In 

 walking, the motion at the hip is very limited, and the leg is dragged, 

 while at rest it is relieved from bearing its share in sustaining the 

 body. An intelligent opinion and correct conclusion will depend 

 largely upon a knowledge of the history of the case, and while in 

 some instances that will be but a report of the common etiology of 

 fractures, siich as blows, hurts, and other external violence, the sim- 

 ple fact of a fall may furnish in a single word a satisfactory solution 

 of the whole matter. 



With the exception of the deformity of the ilium in a fracture of its 

 external angle, and unless there have been a serious laceration of tis- 

 sues and infiltration of blood, or excessive disi3lacement, there are no 

 very definite external symptoms in a case of a fracture of the hip 

 bone. There is one, however, which, in a majority of cases, will not 

 fail — it is crepitation. This evidence is attainable by both external 

 and internal examination — by manipulation of the gluteal surface and 

 by rectal taxis. Very often a lateral motion, or balancing of the 

 hinder parts by pressing the body from one side to the other, will be 

 sufficient to render the crepitation more distinct — a slight sensation 

 of grating, which may be jjerceived even through the thick coating of 

 muscle which covers the bone — and the sensation may not onl}^ be felt, 

 but to the ear of the expert may even become audible. This external 

 manifestation is, however, not always sufficient in itself, and should 

 always be associated with the rectal taxis for corroboration. It is true 

 that this may fail to add to the evidence of fracture, but till then 

 the simple testimony afforded by the detection of crepitation from the 

 surface, though a strong confirmatory point, is scarcely sufficiently 

 absolute to establish more than a reasonable probabilitj'^ or strong 

 suspicion in the case. 



In addition to the fact that the rectal examination brings the 

 exploring hand of the surgeon into near proximity to the desired 

 point of search, and to an accurate knowledge of the situation of 

 parts, both pro and con as respects his own views, there is another 

 advantage attendant upon it which is well entitled to appreciation. 

 This is the facility with Avhich he can avail himself of the cooperation 

 of an assistant, who can aid him by manipulating the implicated limb 

 5961— HOR 11 



