FRACTUEE OF THE FEMUR. 323 



plaster of Paris dressing about the leg, extending down to the fet- 

 lock. Place the animal in a roomy box stall well provided with bed- 

 ding so that he can lie down, to prevent founder. 



FRACTURE OF THE FEMUR. 



The protection which this bone receives from the large mass of 

 muscles in which it is enveloped does not suffice to invest it with 

 immunity in regard to fractures. 



Cause. — It contributes its share to the list of accidents of this 

 description, sometimes in consequence of external violence and some- 

 times as the result of muscular contraction; sometimes it takes place 

 at the upper extremity of the bone; sometimes at the lower; some- 

 times at the head, when the condyles become implicated; but it is 

 principally found in the body or diaphysis. The fracture may be of 

 any of the ordinary forms, simple or compound, complete or incom- 

 plete, transverse or oblique, etc. A case of the comminuted variety 

 is recorded in which eighty-five fragments of bone were counted and 

 removed. 



The thickness of the muscular covering sometimes renders the 

 diagnosis difficult by interfering with the manipulation, but the crepi- 

 tation test is readily available, even when the swelling is considerable, 

 and which is likely to be the case as the result of the interstitial hem- 

 orrhage which naturally follows the laceration of the blood vessels of 

 the region involved. 



Symptoms. — If the fracture is at the neck of the bone the muscles 

 of that region (the gluteal) are firmly contracted and the leg seems to 

 be shortened in consequence. Locomotion is impossible. There is 

 intense pain and violent sweating at first. Crepitation may in some 

 cases be discerned by rectal examination, with one hand resting over 

 the coxo-femoral (hip) articulation. Fractures of the tuberosities of 

 the upper end of the bone, the great trochanter, may be identified by 

 the deformity, the swelling, the impossibility of rotation, and the 

 dragging of the leg in walking. Fracture 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 cautiousl3^ The manipulations for the dis- 

 covery 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. 



Treatment. — The question as to treatment in fractures of this 

 description resolves itself into the query whether any treatment can 

 be suggested that will avail anything practically as a curative meas- 

 ure; whether, upon the hypothesis of reduction as an accomplished 



