. The diseases of children : medical and surgical. ise reduced the arm should certainly be put upin full flexion. At the end of a week the splints should be removed, gentleactive movement encouraged, and the splints re-adjusted. A week later allsplints should be left off and the arm worn in a sling, but taken out nightand morning for gentle exercise. Violent passive movement to keep upflexibility is mischievous and delays the cure, since the irritation increasesthe amount of callus thrown out. If no passive or forcible movement isallowed, but just gentle voluntary exercise, absorption of all t
. The diseases of children : medical and surgical. ise reduced the arm should certainly be put upin full flexion. At the end of a week the splints should be removed, gentleactive movement encouraged, and the splints re-adjusted. A week later allsplints should be left off and the arm worn in a sling, but taken out nightand morning for gentle exercise. Violent passive movement to keep upflexibility is mischievous and delays the cure, since the irritation increasesthe amount of callus thrown out. If no passive or forcible movement isallowed, but just gentle voluntary exercise, absorption of all thickeninggradually takes place, and, provided the displacement has been fairlycorrected, almost perfect mobility will return in the course of a few great point in treatment is to reduce the deformity and avoid forciblemovement, but encourage gejitle active movements after about the end ofthe first week. The ultimate prognosis is good as regards mobility, thoughuncertain as to arrest of growth. It occasionally happens that after separa-. Fig. 211.—Separation of the lower epiphysis of the radius (photograph by Franic Ashe, ). tion of the whole lower humeral epiphysis union takes place with thelower segment of the limb adducted, there is loss of the carryingangle, and an unsightly and somewhat awkward limb {vide fig. 209 andPlate VI.). Loss of the carrying angle or cubitus varus may arise ininjuries of the elbow from displacement of one or other side of the lower endof the humerus or from abnormal growth after injury. It is very unsightly,but does not very seriously interfere with the use of the arm in most one case we twice osteotomised the humerus to remedy the deformity,which, however, recurred. Even if the limb is in the natural position after theaccident, it may become deformed in the course of subsequent growth (Piatt).Separation of the epicondylar epiphysis is fairly common in patients fromten to sixteen years old, and the displacement is usua
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