s._--This variety of fracture is easily recognized by the
appearance of the leg and the different changes it undergoes. There is
inability to use the limb; impossibility of locomotion; mobility below
the injury; the ready detection of crepitation--in a word, the
assemblage of all the signs and symptoms which have been already
considered as associated with the history of broken bones.
The fracture of the ulna alone, principally above the radio-ulnar arch,
may be ascertained by the aggravated lameness, the excessive soreness on
pressure, and perhaps a certain increase of motion, with a very slight
crepitation if tested in the usual way. Displacement is not likely to
take place except when it is well up toward the olecranon or its
tuberosity, the upper segment of the bone being in that case likely to
be drawn upward. For a simple fracture of this region there is a fair
chance of recovery, but in a case of the compound and comminuted class
there is less ground for a favorable prognosis, especially if the elbow
joint has suffered injury. A fracture of the ulna alone is not of
serious importance, except when the same conditions prevail. A fracture
of the olecranon is less amenable to treatment, and promises little
better than a ligamentous union.
_Treatment._--Considering all the various conditions involving the
nature and extent of these lesions, the position and direction of the
bones of the forearm are such as to render the chances for recovery from
fracture as among the best. The reduction, by extension and
counterextension; the maintenance of the coaptation of the segments; the
adaptation of the dressing by splints, oakum, and agglutinative
mixtures; in fact, all the details of treatment may be here fulfilled
with a degree of facility and precision not attainable in any other part
of the organism. An important, if not an essential, point, however, must
be emphasized in regard to the splints. Whether they are of metal, wood,
or other material, they should reach from the elbow joint to the ground,
and should be placed on the posterior face and on both sides of the leg.
This is then to be so confined in a properly constructed box as to
preclude all possibility of motion, while yet it must sustain a certain
portion of the weight of the body. The iron splint (represented in Plate
XXX) recommended by Bourgelat is designed for fractures of the forearm,
of the knee, and of the cannon bone, and will prove to be an appliance
of
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