A system of surgery . probable; later, amixed separation and fracture are more likely. The fracture maybe incomplete, the epiphysis being bent inwards or outwards. Inone case (age 12) examined anatomically, the epicondyles did notaccompany the capitellum and trochlea. In over fifty cases (between1|- to 14 years) J. Hutchinson, junr., found no instance of suppura-tion in a simple case. Callus in front of the joint tends to beexuberant and to limit flexion, especially if reduction be imperfect. Signs.—As in supra-condyloid fractures in complete may be no displacement, only an antero-
A system of surgery . probable; later, amixed separation and fracture are more likely. The fracture maybe incomplete, the epiphysis being bent inwards or outwards. Inone case (age 12) examined anatomically, the epicondyles did notaccompany the capitellum and trochlea. In over fifty cases (between1|- to 14 years) J. Hutchinson, junr., found no instance of suppura-tion in a simple case. Callus in front of the joint tends to beexuberant and to limit flexion, especially if reduction be imperfect. Signs.—As in supra-condyloid fractures in complete may be no displacement, only an antero-posterior give justabove the elbow (J. Hutchinson, junr.). 3. The T-fracSaire (Fig. 255) consists of a more or less trans-verse fissure, crossing the bone at a varying height above thearticular surface, and of another, vertical, which descends from theformer and generally through the trochlea. It is not very common,and usually occurs in adults, being almost always the result of direct FRAG TUBES OF THE HUMERUS. 819. violence—falls or blows upon the elbow; still greater force maycause much comminution. A fracture of the olecranon is a notinfrequent concomitant of these serious injuries, which are alwaysaccompanied by great swelling and are often compound or complicatedby injuries to nerves or vessels. As to displace-ment—almost anything may happen; but usuallythe lower fragments are drawn backwards andupwards, whilst the upperf ragment sinks towardsthe joint between them, forcing them apart. Signs.—If there be not too much swelling,the lower end of the humerus seems muchwidened; everything is loose, crepitus perceivedat each movement; the relations between theolecranon and epicondyles are more or less ab-normal, yet the sigmoid notch and radial headcannot be felt; when extension is made, thecondyles can be pressed together, and movedupon each other. 4. Fractures of the trochlea or capi-tellum, usually with the corresponding epicon-dyle, are common accidents in this regio
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