region due to strains, contusions or penetrant wounds; paralysis of the
brachial plexus or of the prescapular nerve; involvement of lymph
glands; arterial thrombosis; metastatic infections; rheumatic
disturbances; and as the result of inflammation, infectious or
non-infectious occasioned by collar bruises. In some instances such
inflammation is due to the manner of treatment of collar injuries.
Therefore, when one considers the numerous and dissimilar possible
causes of shoulder lameness, it behooves the practitioner to become
proficient in diagnostic principles.

A principle which is elemental in the diagnosis of locomotory
impediment, is that lameness of the shoulder or hip is usually
manifested by more or less difficulty in swinging the affected member.
Swinging-leg-lameness, then, is usually present in shoulder affections.
In some instances lameness is mixed as in joint ailments, involvement of
the bicipital bursa (bursa intertubercularis), etc. In affections of the
extremity there exists supporting leg lameness. Consequently, we employ
this elemental principle, and, by a visual examination of the subject,
which is being made to travel suitably, one may decide that lameness is
either "high up"--shoulder lameness or, "low down"--of the extremity.

[Illustration: Fig. 5--Ordinary type of heavy sling.]

To make practical use of this principle, the examiner must be thoroughly
familiar with the anatomy of the various structures concerned in
advancing the leg--those which support weight as well as those concerned
both in weight bearing and swinging the member.


Fracture of the Scapula.