A system of surgery . padover the epicondyle)should be substitutedfor one of the above,fixed to the fore-armby bandage, and exten-sion should then bemade, as shown in , until shorteningis removed ; thebuckles should thenbe tightened. Frac-tures so high that nosatisfactory hold abovethe fracture can beobtained by the upperstrap are best treatedlike fractures of thesurgical neck. Pseudarthrosis iscommoner in the humerus than in any other long bone, especiallyin the middle third (Fig. 229). Fractures of the lower end of the humerus.—These injuries are very frequent in the first and second
A system of surgery . padover the epicondyle)should be substitutedfor one of the above,fixed to the fore-armby bandage, and exten-sion should then bemade, as shown in , until shorteningis removed ; thebuckles should thenbe tightened. Frac-tures so high that nosatisfactory hold abovethe fracture can beobtained by the upperstrap are best treatedlike fractures of thesurgical neck. Pseudarthrosis iscommoner in the humerus than in any other long bone, especiallyin the middle third (Fig. 229). Fractures of the lower end of the humerus.—These injuries are very frequent in the first and second decennia; if Brunssstatement, based on 4,000 hospital cases, may be trusted, theyare comparatively rare after forty. There are several types de-scribed. (1) The supra-condyloid ; (2) separation of the whole lowerepiphysis; (3) the T-fracture and comminuted fractures ; (4) frac-ture of the capitellum or of the trochlea ; (5) fracture of the internalor external epicondyle or separation of the corresponding Fig. 254.—Treatment of Fracture of the Shaft of the Hume-rus by internal angular and short side Splints. The handand fore-arm are bandaged ; the splints are buckledloosely round the arm ; extension is being made from theelbow, whilst a towel held by an assistant forms a pointof counter-extension ; the surgeon tests the result with atape. 818 INJURIES OF BONES. 1. Supra-comlyloid fracture* in which a transverse or obliquefracture crosses the bone above the epicondyles : the lower fragment,with the fore-arm bones in their normal relation to it, is usuallydrawn backwards by the triceps, moving on the lower end of theupper fragment as upon a hinge, or displaced wholly backwardsbehind the upper. Signs.—Seen from the side, with the fore-arm flexed or hanging,the elbow projects markedly backwards, but its point is not veryacute; there is bony swelling in front, immediately above the flexorfold, and an obtuse angle opening backwards and upwards at thesame level behind
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