348 DISEASES OF THE HOKSE. 



ol any of the ordinary forms, simple or compound, complete or 

 incomplete, transverse or oblique, etc. A case of the comminuted 

 variety is recorded in which 85 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 consider- 

 able, and which is liable to be the case as the result of the inter- 

 stitial hemorrhage which naturally follows the laceration of the blood 

 vessels of the region involved. 



Symptoms.— il 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 rest- 

 ing over the coxo- femoral (hip) articulation. Fractures of the tuber- 

 osities 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 with displacement, and as a consequence a short- 

 ening of the leg, which is carried forward. The lameness is exces- 

 sive, the foot being moved, both when raising it from the ground 

 and when setting it down, very timidly and cautiously. The ma- 

 nipulations for the discovery of crepitation always cause much pain. 

 Lesions of the lower end of the bone are more difficult to diagnosti- 

 cate with certainty, though the manifestation of pain while making 

 heavy pressure upon the condyles will be so marked that only crepi- 

 tation will be needed to turn a suspicion into a certainty. 



2'reatm^nt. — 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 accomplishe'd 

 fact, any permanent or efficient device as a means of retention is 

 within the scope of human ingenuity. If the reduction were success- 

 fully performed, would it be possible to keep the parts in place by 

 any known means at our disposal? At the best the most favorable 

 result that could be anticipated would be a reunion of the fragments 

 with a considerable shortening of the bone and a helpless, limping, 

 crippled animal to remind us that for human achievement there is 

 a " thus far and no farther." 



In small animals, such as dogs and cats, however, attempts at 

 treatment are justifiable, and we are convinced that in many cases 

 of difficulty in the application of splints and bandages a patient 

 may be placed in a condition of undisturbed quiet and left to the 

 processes of nature for "treatment" as safely and with as good an 



