The practice of surgery . drag-ged downwards by the weight of thearm, and forwards and inwards by the action of the subclavius, the attachment of this muscle to the firstrib being then the fixed point. [When the point of fracture is near the acromial extremity, wherethe bone is broad, there may be no displacement at first, and but little,perhaps, at any subsequent period. This is owing, partly to the breadthof the bone, and partly to the existence of ligamentous fibres, unrupturedby the violence, which hold the fragments in apposition. Frequently,however, unless the accident is recognized and
The practice of surgery . drag-ged downwards by the weight of thearm, and forwards and inwards by the action of the subclavius, the attachment of this muscle to the firstrib being then the fixed point. [When the point of fracture is near the acromial extremity, wherethe bone is broad, there may be no displacement at first, and but little,perhaps, at any subsequent period. This is owing, partly to the breadthof the bone, and partly to the existence of ligamentous fibres, unrupturedby the violence, which hold the fragments in apposition. Frequently,however, unless the accident is recognized and properly treated at first,some sudden movement, as in throwing a stone, or lifting any heavyarticle, separates the fragments and reveals the true nature of the acci-dent, at the expiration of a few days. When there is doubt, therefore,as to the existence of fracture, the patient should be carefully watched,or a fracture dressing be applied at once.—Ed.] The indications of treatment are plain, but unfortunately not very. [The ordinary site of Fracture of the Clavicle.(in m Fcrgusfon.)—Ed.] 310 FRACTURE OF THE CLAVICLE. Fig. 136. easily fulfilled. They are to raise the acromial portion to the samelevel with the sternal, to retain it there, and at the same time to keepthe shoulder removed from the sternum, so as to prevent displacementinwards, and consequent riding of the ends of the bone. Many andcomplicated are the means devised for this end. The simplest, mosteasily obtained, and not the least efficient, are as follows: A wedge-shaped pad is placed in the axilla, sufficiently large to occupy thatcavity completely. The best pad is made of horse-hair, covered withsoft leather, but any temporary substitute may be taken at the firstdressing. By means of a shawl or large handkerchief, within which itis placed, the pad is securely lodged in the axilla, and, by tying theends over the opposite shoulder tightly, elevation of the shoulder, andconsequently of the acromial portion of t
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