Virginia medical semi-monthly . ed and soon forgotten, but theman who had a deformed arm or shortened legfrom a badly treated fracture, lives for a gen-eration a walking or limping advertisement tohis community of surgical limitation or inca-pacity. Let us, therefore, study fractures morein order that we may treat them better—if notfor the sake of our patients, then for the sake ofour profession. But little has been learned and much has been 122 THE VIRGINIA MEDICAL SEMI-MONTHLY. [June 24, forgotten in regard to the immediate treatmentof simple fractures since the publication of theclassical w
Virginia medical semi-monthly . ed and soon forgotten, but theman who had a deformed arm or shortened legfrom a badly treated fracture, lives for a gen-eration a walking or limping advertisement tohis community of surgical limitation or inca-pacity. Let us, therefore, study fractures morein order that we may treat them better—if notfor the sake of our patients, then for the sake ofour profession. But little has been learned and much has been 122 THE VIRGINIA MEDICAL SEMI-MONTHLY. [June 24, forgotten in regard to the immediate treatmentof simple fractures since the publication of theclassical work of Malgaigne more than fiftyyears ago, and as this and other books are ac-cessible to the profession, I will limit my papeito a brief review of what has been accomplished,and what remains to be done, in the treatment ofa special class of cases commonly called un-united fractures. When a bone fails to unite after being immo-bilized for a certain length of time the conditioni? spoken of as either delayed union or Case I. Ununited fracture of humerus one yearafter operation. Silver wire suture indicatesline of union. Delayed union is where reparative action ispresent, but owing to lack of nutritive vigor,callus is either tardy in development or imper-fect in its transformation. Improvement ofthe genera] health, the establishment of a moreperfect local circulation, or the irritation of theseat of injury by- forcibly rubbing the frag-ments together may stimulate the halting pro-cess and finally residt in solid union. Non-union is where reparative action is ab- sent, from local or constitutional causes, andthe result is either a ligamentous union or theformation of a false joint. The ends of thebones round off, the medullary cavities becomeclosed, and the blood supply to the part is di-minished. There is always abnormal mobility,often displacement of the fragments, and some-times absorption of the bone. The division of ununited fractures into de-layed union or non-u
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