Atlas and epitome of traumatic fractures and dislocations . essing applied to the forearm in the treatmentof a T-fracture. wire splints recommended for fractures of the shaft of thehumerus and illustrated on page 167 may be used (seealso Fig. 67, page 167). The importance of careful re-duction and constant supervision cannot be emphasized toostrongly. I am in the habit of anesthetizing the children,not only at the first dressing, but in some cases also atsubsequent dressings. The dressing should be changed atshort intervals. Passive movements, massage, etc., mustbe begun early. Improper treatm
Atlas and epitome of traumatic fractures and dislocations . essing applied to the forearm in the treatmentof a T-fracture. wire splints recommended for fractures of the shaft of thehumerus and illustrated on page 167 may be used (seealso Fig. 67, page 167). The importance of careful re-duction and constant supervision cannot be emphasized toostrongly. I am in the habit of anesthetizing the children,not only at the first dressing, but in some cases also atsubsequent dressings. The dressing should be changed atshort intervals. Passive movements, massage, etc., mustbe begun early. Improper treatment may result in unionwith outward (varus) or inward (valgus) deformity of thelimb (Plate 37). [The position of the forearm, flexion or extension, is a 178 FRACTURES AND DISLOCATIONS. much disputed point. This subject of elbow fractures inchildren has recently been exhaustively studied and dis-cussed by Fred. J. Cotton, of Boston/ who concludesthat in the majority of instances the position of aeuteflexion seems to have given the best results, although he. Fig. 79.—Paralysis of the musculospiral after compound fracture ofthe lower end of the humerus. The scar is seen at the elbow (boy,eight years old). agrees with the majority of authors that the most impor-tant point in the treatment is proper reduction. Scudder ^recommends the position of acute flexion, although it maynot be possible at the first or second dressing. The expe- ^ Annals of Surgery, Feb. and Mar., 1902. 2 The Treatment of Fractures, Saunders <& Co., Phila., 1900. FRACTURES OF THE UPPER EXTREMPTY. 179 rience in the surgical clinic of the Johns Hopkins Hos-pital also favors this position. It is a much simplermethod than the extension position.—Ed.] As regards accessory injuries, the ulnar nerve is morerarely involved than tlie musculos})iral and median,which are sometimes completely divided; that these com-plications must be carefully, and as a rule at once, treatedby operation -needs no more than a passing
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