ee thus held, and bandage this in
place. Keep sponge and bandage wet with ice water. If no sponge is
available, half fill rubber hot-water bottle with cracked ice, and lay
this over knee joint. Put patient to bed._

Fracture of kneepan is caused either by direct violence or muscular
strain. It more frequently occurs in young adults. Immediate pain is
felt in the knee and walking becomes impossible; in fact, often the
patient cannot rise from the ground after the accident. Swelling at
first is slight, but increases enormously within a few hours.
Immediately after the injury it may be possible to feel the separate
broken fragments of the kneepan and to recognize that they are
separated by a considerable space if the break is horizontally across
the bone.

[Illustration: FIG. 26.

A BROKEN KNEEPAN (SCUDDER).

A padded splint, supporting knee, is shown reaching from ankle to
thigh. Note number and location of adhesive plaster strips.]

Nothing can be done to set the fracture until the swelling about the
joint has been reduced, so that the first treatment consists in
securing immediate rest for the kneejoint, and immobility of the
fragments. A splint made of board, about a quarter of an inch thick
and about four inches wide for an adult, reaching from the upper part
of the thigh above to a little above the ankle below, is applied to
the back of the limb and well padded, especially to fill the space
behind the knee. The splint is attached to the limb by straps of
adhesive plaster two inches and a half wide; one around the lower end
of the splint, one around the upper part, and the third placed just
below the knee. To prevent and arrest the swelling and pain, pressure
is then made on the knee by bandaging.

One of the best methods (Scudder's) is to bind a large, flat, dry
sponge over the knee and then keep it wet with cold water; or to apply
an ice bag directly to the swollen knee; a splint in either case being
the first requisite. The patient should of course be put to bed as
soon as possible after the accident, and should lie on the back with
the injured leg elevated on a pillow with a cradle to keep the clothes
from pressing on the injured limb. (See cut, p. 110.)

=FRACTURE OF LEG BONES, BETWEEN KNEE AND ANKLE.=

_First Aid Rule.--Handle very carefully; great danger of making
opening to surface. Special painful point, angle or new joint in bone,
disability, and grating felt will decide existence of break. Let