rave import.

The prognosis as regards the _function of the limb_ should always be
guarded, even in simple fractures. Incidental complications are liable
to arise, delaying recovery and preventing a satisfactory result, and
these not only lead to disappointment, but may even form a ground for
actions for malpraxis.

The chief and most frequent cause of permanent disability after
fracture is angular displacement. A comparatively small degree of
angularity may lead to serious loss of function, especially in the
lower limb; the joints above and below the fracture are placed at a
disadvantage, arthritic changes result from the abnormal strain to
which they are subjected, and rarefaction of the bone may also ensue.

Fibrous union is a common result in fractures of the neck of the femur
in old people and in certain other fractures, such as fracture of the
patella, of the olecranon, coronoid and coracoid processes, and
although this does not necessarily involve interference with function,
the patient should always be warned of the possibility.

Impairment of growth and eventual shortening of the limb may result
from involvement of an epiphysial junction.

Stiffness of joints is liable to follow fractures implicating
articular surfaces, or it may result from arthritic changes following
upon the injury.

Osseous ankylosis is not a common sequel of simple fractures, but
locking of joints from the mechanical impediment produced by the
union of imperfectly reduced fragments, or from masses of callus, is
not uncommon, especially in the region of the elbow.

Wasting of the muscles and oedema of the limb often delay the complete
restoration of function. Delayed union, want of union, and the
formation of a false joint have already been referred to.

#Treatment.#--The treatment of a fracture should be commenced as soon
after the accident as possible, before the muscles become contracted
and hold the fragments in abnormal positions, and before the blood and
serum effused into the tissues undergo organisation.

Care must be taken during the transport of the patient that no further
damage is done to the injured limb. To this end the part must be
secured in some form of extemporised splint, the apparatus being so
designed as to control not only the broken fragments, but also the
joints above and below the fracture.

When the ordinary method of removing the clothes involves any risk of
unduly moving the injured part, they should