322 



and placing' il in various positions, so far as the j)atient Avill permit, 

 while the surgeon himself is making explorations and studying the 

 effect from A^ithin. By this method he can hardly fail to ascertain 

 the character of the fracture and the condition of the bony ends. By 

 tlie rectal taxis, as if with eyes in the finger ends, he will " see " what 

 is the extent of the fracture of the ilium or of the neck of that bone; 

 to Avhat ijart of the central portion of the bone (the acetabulum) it 

 reaches; whether this is free from disease ornot, and in what location 

 on the floor of the pelvis the lesion is situated. We have frequently, 

 by this method, been able to detect a fracture at the sj-mphysis which, 

 from its history and s^-mptoms and an external examination, could 

 only have been guessed at. 



Yet, with all its advantages, the rectal examination is not always 

 necessary, as, for example, when the fracture is at the posterior and 

 external angle of the ischium, when by friction of the bony ends tlie 

 surgeon may discern the crepitation without it. 



Every variety of complication, including muscular lacerations with 

 the formation of deep abscesses and injuries to the organs of the i^elvic 

 cavity, the bladder, the rectum, and the uterus, may be associated 

 with fractures of the hip bone. 



The prognosis of these lesions will necessarily vary considerably. 

 A fracture of the most superficial part of the bone of the ilium or of 

 the ischium, especially where there is little displacement, will unite 

 rajiidly, leaving a com];)aratively sound animal often quite free from 

 subsequent lameness. But if there is much dis]3lacement, only a liga- 

 mentous union will take place, with much deformity and more or less 

 irregularity in the gait. Other fractures may be followed by comjilete 

 disability of the patient, as, for example, when the cotyloid cavity is 

 involved, or when the reparatory process has left bony deposits in the 

 pelvic cavity at the seat of the union, which may, with the female, 

 interfere with the steps of parturition, or induce some iocal paralysis 

 by ijressure ui)on the nerves which govern the muscles of the hind 

 legs. This is a condition not infrequently observed when the callus 

 has been formed on the floor of the i^elvis near the obturator foramen, 

 pressing upon the course or involving the obturator nerve. 



The treatment of all fractures of the hip bone should, in our esti- 

 mation, be of the simplest kind. Rendered comx^aratively immovable 

 b}^ the thickness of the muscles by which the region is enveloped, one 

 essential indication suggests itself, and that is, to place the animal in 

 a position which, as far as possible, will be fixed and i^ermancnt. For 

 the accomplishment of this purpose the best measure, as we consider 

 it, is to place him in a stall of just sufficient Avidtli to admit him, and 

 to apply a set of slings snugly, but comfortably. This will fulfill the 

 essential conditions of recovery, rest, and immobility. Blistering 

 applications would be injurious, though the adhesive mixture miglit 

 prove in some degree beneficial. 



