Fracture of the posterior parts of the bone (ischium), which forms the point of the buttocks occasionally occurs. The buttock on the injured side will be less prominent than the other. Careful manipulation will generally move the parts so that crepitus may be recognized. If the fracture is through the posterior part of the bone, it is unimportant and deserving of no more attention than placing the animal in such position as to insure it against subsequent injury until the bones are united. Some distortion may result, but not sufficient to warrant interference.
Fracture through the body of the bone on a line with the hip joint (acetabulum) occasionally, though rarely, occurs, and is nearly always associated with dislocation of the hip joint and the forcing of the head of the upper bone of the leg (femur) upward, far out of its place. The violent contraction of the powerful muscles of the hip renders it impossible to reduce the dislocation, and even if it were possible the fractured pelvis could not be held in position, so that the case becomes at once hopeless. It may be recognized by the animal's standing on three legs, the leg on the injured side seeming shorter than its fellow and hanging pendulous, the muscles of the hip violently contracted and hard to the touch. The animal evinces great pain when the limb is moved. There is liable to be some apparent distortion in the relations between the point of the hip and the point of the buttock. This will be more readily noticed by comparing the injured side with the other. The parts may be moved so as to produce crepitus. The examination may be completed by introducing the oiled hand into the vagina or rectum, when the two sides of the pelvis will reveal well-marked differences.
Fracture of the point of the hip.—The anterior and external part of the pelvis (ilium), commonly known as the point of the hip, is liable to fracture, which stock owners describe as "hipping," or being "hipped," or having the hip "knocked down." This accident may be the result of crowding while passing through a narrow door, of falling violently on the point of the hip, or from a violent blow directed downward and forward against it. The lesion generally extends across the flat surface of the bone from its outer and posterior edge forward and inward. Distortion is liable to be the only noticeable symptom. The detached portion varies in size in different cases and with it the resulting deformity. The animal is noticed to be slightly lame, but this symptom soon disappears. The detached portion of the bone is drawn downward and away from the main part by the action of the muscles below, which are so powerful as to render return impossible. The bones therefore remain permanently separated, union taking place by fibrous callus. The animal suffers very little inconvenience, and for practical use may be as serviceable as before the accident, though the distorted appearance depreciates its value.
Fracture of the ribs.—Such an occurrence can take place only as the result of a direct injury, as from blows or crowding. The posterior ribs, being more exposed, are more liable to fracture. Pain in moving, slight swelling over the seat of injury, and difficult breathing are obvious symptoms. If the fracture is complete, crepitation may be occasionally noticed by placing the hand flat over the injured part, carefully observing the motion as the chest contracts and expands during respiration. This symptom is more noticeable when the animal coughs. Unless the point of the broken bone penetrates the cavity of the chest the fracture is usually unimportant and calls for no treatment other than quiet. If the breathing is very labored and attended with much pain, motion may be limited by applying a wide bandage firmly around the chest. The animal should be restricted in the amount of feed and water for a few days, the stomach being kept as nearly empty as possible. Sloppy feed should be given to encourage, as much as possible, free action of the diaphragm in breathing.
Fracture of bones of the limbs.—On this subject much has been said in the preceding remarks on general fractures. As a rule, fracture through one of the large bones of the shoulder (scapula) or thigh (femur) is very difficult to manage. The powerful contraction of the muscles and the changing shape of the limb resulting from their action renders it impossible to retain the detached parts of the bone in proper position. Therefore, though the union should take place, there is almost sure to be considerable deformity and more or less lameness. Fracture of the arm (humerus) or leg (tibia) is likely to be attended with better results. The muscular covering is not so thick, the sheath in which they are held is more tense, and the change in the shape of the limb from muscular action not so noticeable, the muscular force not so great, all of which facilitate replacing the dislodged ends and retaining them.
Fracture of the knee (carpus) and hock (tarsus).—This seldom occurs unless it is the result of a very violent injury, and is generally associated with other injury and serious complications. Displacement does not generally occur to any considerable extent. The treatment, of course, consists in holding the limb perfectly quiet in a natural position, which may be done by the application of long, wooden splints retained by bandages, or a plaster-of-Paris bandage.
Fractures below the knee.—Fracture of the long bone below the knee (metacarpus) and hock (metatarsus) is more common. In young animals of quiet temperament the treatment of simple fractures here is likely to be attended with good results. On the other hand, a compound fracture in this region becomes a serious matter. The structures which surround the bones are so thin that a very small degree of sloughing will expose parts of the bones and be liable to lead to serious complications and probably fatal results.
Fractures of bones below the fetlock.—These fractures are comparatively unimportant unless associated with other serious injury. The parts can generally be held in position without much difficulty, and union generally takes place quite rapidly.
Appliances.—Of the appliances used in the treatment of the fracture of limbs above the knee, splints made of wood or iron strips and bandages are likely to serve best. Below the knee plaster-of-Paris bandages are preferable. The writer is well aware that many of the standard authors deprecate the use of the latter, but an extensive experience leads me to believe that they have many advantages over any of the other appliances when used alone, and in many ways they may be used with advantage in combination with others.