The treatment of fractures . grateful to the patient and promotethe circulation in the skin. 162 The Treatment of Fractures. If the fragments have slipped out of place theyshould be restored by the proper manipulations(usually the same as were necessary at the first set-ting), and a fresh dressing applied. The necessityfor this is very humiliating to the surgeon, but it isfar better to face the obloquy and meet the emer-gency at this period when the accident may be re-paired than to allow very faulty apposition to unitefirmly, and permanent distortion to result afterwards. The second cast shou
The treatment of fractures . grateful to the patient and promotethe circulation in the skin. 162 The Treatment of Fractures. If the fragments have slipped out of place theyshould be restored by the proper manipulations(usually the same as were necessary at the first set-ting), and a fresh dressing applied. The necessityfor this is very humiliating to the surgeon, but it isfar better to face the obloquy and meet the emer-gency at this period when the accident may be re-paired than to allow very faulty apposition to unitefirmly, and permanent distortion to result afterwards. The second cast should remain on for two or threeweeks if all goes well. After the second cast has be-come firm and proves comfortable the patient, as arule (especially after transverse fractures), may beallowed to be out of bed, and in a day or two beallowed to go about on crutches. In the using ofcrutches in these cases I wish to emphasize the im-portance and value of the patient wearing a raisedshoe (high heel and thickened sole) on the un-. Skiagraph showing an oblique fracture of the tibia partlyunited. The fragments have slipped out of proper position. injured extremity, so that his injured extremity may be quite clear of the floor when he walks. This will obviate the necessity of flexing the leg at the knee or swinging it forward by flexing the thigh. Both of these positions are tiresome and the muscular action required is apt to displace the fragments. FRACTURES OF THE BOSTES OF THE LEG. 103 After five weeks, as a rule, the cast or splints maybe discarded; the extremity should be massaged daily,rubbed thoroughly with alcohol and bandaged with aflannel or stockinet bandage. Walking may now betentatively begun with the assistance of crutches, atfirst only a little weight put on the injured passive movement of the ankle-joint and toes,and gradually increasing active movement at thesejoints should be enjoined. After six weeks, in favor-able oases, the patient may discar
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