Notes on the modern treatment of fractures . ixation is satisfactorily obtained by nailing the frag-ments together with long nails driven through the shin. The occasional deformity and limitation of motion, result-ing from fractures of the condyloid portion of the humerus,are doubtless due not only to incomplete reduction of thebroken bone; but to an imperfect fixation, which has allowedthe properly adjusted fragments to slip again into abnormalrelations. Stimson is probably not alone in his belief * that in intercondyloid fracture with marked separation, there isno practicable means surely to
Notes on the modern treatment of fractures . ixation is satisfactorily obtained by nailing the frag-ments together with long nails driven through the shin. The occasional deformity and limitation of motion, result-ing from fractures of the condyloid portion of the humerus,are doubtless due not only to incomplete reduction of thebroken bone; but to an imperfect fixation, which has allowedthe properly adjusted fragments to slip again into abnormalrelations. Stimson is probably not alone in his belief * that in intercondyloid fracture with marked separation, there isno practicable means surely to maintain reduction. He saysfurther that the impossibility of direct control of the frag-ments, the contraction of muscles, and the pressure of fasciacombine to make the result largely a matter of chance. Thisopinion was confirmed, he states, by seeing and feeling in open * Transactions American Surgical Association, ix., 1891, p. 272. CONDYLOID FRACTURES OF THE HUMERUS. 83 fractures the difficulty caused by the shiftings of the Fig. 10. Gunstock Deformity of Left Elbow after Fracture of LowerEnd of Humerus. I have been making some experimental observations duringrecent months on the use of nails for direct fixation of frac- 84 THE MODERN TREATMENT OF FRACTURES. tures; having been led to the investigation by my success atthe Philadelphia Polyclinic Hospital in nailing together thefragments of a metacarpal bone. I have found that frac-tures of the condyles of the humerus, made in the cadaver,can be satisfactorily fixed after reduction by driving; wire nails
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