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Show FRACTURE OF THE OLECRANON. TBAC‘IURE OF THE BUMERUS. OF THE FRACTURE OF THE OLECRANON. FRACTURE OF THE HUMERUS; This is the simplest of all fractures. It requires only hm pasteboard splints, one on the inside and the other on the outside of the arm. The fore arm should be hung by a handkerchief, in such a manner that the wrist may be more ‘x' .l' S l I v.7." m. "335th um ‘ Supported than the elbow, so that the weight of the arm, counteracting the action of the muscles, may serve to keep the ends of the bone in their proper place. 1 have seen the imperfect joint formed in the arm bone oftener than in any other. We must endeavour, in this case, by rude motion, to excite inflammation in the ends of the bones, after which the steady binding of the arm with splints, will certainly succeed in uniting the bones. The humerus may be broken very near its head; the neck of the humerus cannot be broken, because there is, in fact, no neck; but, in a young person, the head may be broken oil at the joining of the apophysis. This has been the consequence of the recoil of a musquet, when a lad, in firing his piece, has not rested it on the shoulder, but on the arm bone. Fracture of the humerus, near the head of the bone, is unc- favonrable, because of the strength of the muscle which surround it: the pectoralis major and latissimus dorsi, the deltoidcs and tcres major, act on the lower piece of the bone, and make an essential difference in the case from that of the simple fracture of the middle part of the bone. The force of these muscles should be counteracted by the weight of the arm, slinging it by the wrist only and not supporting the rmflf'v'" '5} "i-‘igfim-ffl-w ... M. , elbow. THE oleeranon may be fractured when a person in running falls, and strikes the elbow on the ground. No marks are required to distinguish when the prominent process of the ulna at the elbow is broken oil‘. It will, however, be observed that this makes quite a peculiar case from the circumstance of the strong triceps muscle being inserted into the process of the bone which is broken 011'. The bent, or relaxed position of the limb, which is the position of ease in most fractures, would here have the worst effect, by mak- ing the body of the ulna recede from the process which is broken oil‘ and attached to the tendon of the triceps. Let the fore arm be extended ; yet not to the utmost stretch. Then the triceps is to be pressed, with a View to relax it, and the oleeranon brought down to its place. Dossils of lint are then placed on the sides and above the oleeranon ; and over these a roller is put on the arm and fore arm. A splint must then be applied on the fore part of the elbow joint withlint beneath it, to fill up the inequality of the joint, so that the fore arm may be prevented from extending fully to the straight line ; and, at the same time, prevented from being bent at all. We must in this case too, be careful to adapt it splint to the inside of the arm, with such a pad as may fill the axilla without too much encroaching on the head of the humerus, or in the least pushing it from its place; then a piece of pasteboard is to be moulded to the shoulder, and the spica bandage applied and continued in the form of a roller on the arm. These cautions are to be attended to ; because, in the first place, by extending the arm too much, the oleeranon, which has been broken 011‘ is pushed from its notch in the lower head of the humerus ; and consequently it does not perfectly and correctly unite with the body of the ulna. VOL. ll. ' S In the na- |
