The same general plan which is ordinarily employed in correcting luxation is indicated here, but because of the heavy musculature of the hip, complete anesthesia is imperative in all such manipulations.

Gluteal Tendo-Synovitis.

The glutens medius (g. maximus) muscle is inserted chiefly by means of two tendons; one to the summit of the trochanter major of the femur and the other passing over the anterior part of the convexity of the trochanter, and being attached to the crest below it.  The trochanter is covered with cartilage, and a bursa (the trochanteric) is interposed between the tendon and the cartilage.

Etiology and Occurrence.—­This affection is probably caused in most instances by direct injury to the parts, such as may be occasioned by being kicked, falling on pavement, or being struck by the body of a heavy wagon.  Strains in pulling or in slipping are undoubtedly causative factors and in draft horses such strains may result in involvement of this synovial apparatus.

Symptomatology.—­If pain be severe and inflammation acute, weight may not be borne with the affected member.  There is some local manifestation of the condition in acute cases.  Swelling of the tissues contiguous to the bursa is present and pain is evinced upon manipulation of the parts.  A characteristic gait marks inflammation of the trochanteric bursa, and as Gunther has put it, the subject generally moves or trots as does the dog—­the sound member being carried in advance of the affected one and the forward stride of the diseased leg is shortened.  In some chronic cases crepitation is discernible by holding the hand on the trochanter while the subject walks.

Treatment.—­In the first stages of an acute affection absolute quiet must be enforced; local antiphlogistic applications are beneficial.  Later, vesication of a liberal area surrounding the trochanter major is indicated.  Where the condition has become chronic in horses that are to be kept at heavy draft work there is little chance for complete recovery.  And, naturally, one is not to expect resolution in cases where there exist erosion and ossification of cartilage—­where crepitation is discernible.

Paralysis of the Hind Leg.

Aside from paraplegic conditions due to disease of the cord or the lumbosacral plexus, and monoplegic affections resultant from disturbances of this plexus, paralysis of certain nerves are occasionally encountered.

Anatomy.—­The lumbosacral plexus results substantially from the union of the ventral branches of the last three lumbar and the first two sacral nerves, but it derives a small root from the third lumbar nerve also.  The anterior part of the plexus lies in front of the internal iliac artery, between the lumbar transverse processes and the psoas minor.  It supplies branches to the iliopsoas[43] (designated by Girard, the iliacomuscular nerves).  The posterior part lies partly upon and partly in the texture of the sacrosciatic ligament.  From the plexus are derived the nerves of the pelvic limb (Sisson).