504 ‘ VETERINARY SURGICAL ‘THERAPEUTICS. 
The treatment varies as to whether the luxation is recent or old. 
When it is-treated before the appearance of the inflammatory phenomena, 
mild interference may sometimes succeed. The articular head has left 
its cavity in perforating the synovial; “through the opening it came 
out, it must re-enter.” After having recognized the direction of the: 
deviation, some few manipulations may be sufficient to replace the 
separated surfaces in their normal position. If the manner in which 
the luxation has taken place is known with some certainty, the first. 
step of the reduction consists in bringing the leg back to the position it 
occupied at the moment of the luxation. By methodical manipulations, 
special to each displacement, the head of a bone can be reintegrated 
in its cavity, and thus a complete return of the relations of the articular 
surfaces can be obtained, while the means of force often increase the 
lesions, produce a new tear in the synovial, or only have for result to 
push it back into the joint and squeeze it between the articular surfaces ; 
reduction is incomplete, return of the trouble aimost certain. But if 
mild method, with or without narcosis, has failed, forcible process 
becomes obligatory. 
In small animals, the operator may perform the extension, counter exten- 
sion and coaptation alone. When operating on horses or cattle, assistants 
are necessary. It would be better to operate standing, so as to avoid 
violent efforts in getting up; but it is generally necessary to cast the 
patient. To,make counter-extension, ropes fixed on the upper region. 
of the leg (round the axilla in the fore extremity, round the groin for 
the hind leg) are pulled upon by assistants, or tied to rings on the floor 
or posts. The cords used for extensions ‘are fixed round the pastern or’ 
above the knee or the hock. The force necessary to overcome mus~ 
cular contraction is sometimes enormous. To overcome it, the method. 
of the continued pulling is recommended. Soon the muscles become. 
relaxed and the reduction is possible. If this means fails, anzesthesia, 
which “leaves the peri-articular muscles without resistance,” is to be: 
resorted to. : 
Pathological anatomy has revealed the changes which occur in a luxa- 
tion which has not been reduced. The old articulation disappears, 
the articular cavity is filled with fibrous tissue; a true nearthrosis is. 
formed round the displaced bony extremity, the surrounding tissues. 
swell, adapt themselves to form pseudo-synovial and tendinous bands. 
A natural recovery takes place, but besides the fact that it goes on 
slowly, there always remains a lameness much marked. The two 
steers mentioned by Cadiot were still very lame thirteen months. 
after a coxo-femoral luxation left to itself. In the reduction of old. 
luxations mild means do not succeed; much force is to be used. 
