radial or to the
ulnar side. In other cases the four broken ends impinge upon the
interosseous space, and may become united to one another, preventing
the movements of pronation and supination. There may be shortening
from overriding of fragments.

When the radius is broken above the insertion of the pronator teres,
its upper fragment may be supinated by the biceps and supinator
muscles, while the lower fragment remains in the usual semi-prone
position. If union takes place in this position, the power of complete
supination is permanently lost.

The usual _symptoms_ of fracture are present, and there is seldom any
difficulty in diagnosis.

The _prognosis_ must be guarded, especially with regard to the
preservation of pronation and supination. These movements are
interfered with if union takes place in a bad position with angular or
rotatory deformity of one or both bones, or if callus is formed in
excess and causes locking of the bones. In some cases the callus fuses
the two bones across the interosseous space, and pronation and
supination are rendered impossible.

Persistent angular deformity of the forearm is also liable to ensue,
either from failure to correct the displacement primarily, or from
subsequent bending due to ill-applied splints or slings. Want of
union, or the formation of a false joint in one or both bones, is
sometimes met with, particularly in children, and, like the
corresponding fracture of the leg, is liable to prove intractable.

A considerable number of cases of gangrene of the hand after simple
fracture of the forearm are on record. This is sometimes attributable
to damage inflicted upon the blood vessels by the fractured bones, or
to the force that caused the fracture, but is oftener due to a roller
bandage applied underneath the splints strangulating the limb, to
injudiciously applied pads, or to too tight bandaging over the
splints. Volkmann's ischaemic contracture occasionally develops after
fractures of the forearm.

In uncomplicated cases, union takes place in from three to four
weeks.

_Treatment._--To ensure accurate reduction and coaptation, a general
anaesthetic is usually necessary. In the greenstick variety the bones
must be straightened, the fracture being rendered complete, if
necessary, for this purpose.

To retain the bones in position, anterior and posterior splints are
then applied. These are made to overlap the forearm by about half an
inch on each side, to avoid c