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In young and rachitic animals outdoor exercise and a good nutritive ration for the subject are indicated. Hypophosphites in assimilable form may be beneficial, and vesication of the patellar region contributes to recovery. Where extreme luxation is present in both stifles, the prognosis is unfavorable.
In such cases, by immobilizing the affected parts as in fracture, and confining the subject in a sling for about sixty days, partial recovery may occur in some instances. Experience has shown that where luxation with detachment of a collateral ligament occurs, recovery is slow and incomplete there always results considerable exostosis at the site of injury. Sesamoiditis. Etiology and Occurrence.
In upward luxation, reduction is effected by attempting further extension of the stifle joint and at the same time the patella is pulled outward, off the internal rim of the trochlea. This is attempted by securing the subject in a standing position; the sound side is kept against a wall if possible and a rope is tied to the extremity of the affected leg.
In extreme cases, as soon as the ailing animal is caused to support weight with the affected member, the joint is suddenly thrown outward in a manner that the average layman at once concludes that there must be scapulohumeral luxation, and the veterinarian receives a call to see a case wherein the "shoulder is out of place." There exists, however, no luxation in such cases.
With the patella disarticulated in this manner, the action of the quapriceps femoral group of muscles has no effect on the stifle joint and, therefore, flexion of this articulation occurs as soon as the subject attempts to sustain weight and the leg collapses unless weight is at once taken up by the other member if sound. As a rule, the reduction of this form of luxation is not difficult.
Among the wise men of Egypt, then in her acme of civilization, there was not one to reduce the simple luxation which any student of the present day would easily diagnose and successfully treat.
Because of immobilization of the stifle and hock joints in upward luxation, the subject can walk only by hopping on the sound leg and then the extremity is flexed, allowing the anterior portion of the fetlock to drag on the ground. Such cases may be styled momentary luxation, whether they are due to a weakened condition of the patellar ligaments or spasmodic contraction of the crural muscles.
Extension of the hock in upward luxation of the patella, permits of flexion of the phalanges. In upward luxation, then, the leg is extended as if too long, but the phalanges may be in a state of moderate flexion. If the foot rests on the ground when the extremity is not flexed, it is almost impossible for the subject to step backward.
Recognition of fracture of any other single carpal bone must be done by detecting crepitation unless it be a compound fracture, whereupon probing is of aid in establishing a diagnosis. Carpal luxation when present is to be recognized by finding the apposing carpal bones joined in an abnormal manner that is, out of position.
Usually, luxation and fracture may be differentiated in that there is no crepitation in luxation and more or less crepitation exists in fracture. It is evident, when one considers the symptomatology and nature of the affection, that fixed luxation is usually caused by undue strain or violent and abnormal movement of a part.
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