454 



AN ADDRESS ON THE TREATMENT OF 



the fractured surfaces, I proceeded to drill the fragments, with a view to the 

 application of the suture. The fracture was oblique from before backwards, 

 as indicated by this diagram. I found no difficulty, with the proximal frag- 

 ment, in making the drill appear upon the fractured surface at a little distance 

 from the cartilage (see h, Fig. i), but with the other fragment the obliquity 

 of the position in which the drill had to be placed was so great that, instead 

 of the end of the drill emerging at the fractured surface, as I had intended, 

 I found it had entered into the substance of the humerus (d, Fig. i). I there- 

 fore withdrew the drill, and substituted for it a needle (c d), passing the eyed 

 end in first. Then, with a gouge, I excavated an opening (e) upon the fractured 



Fig. I. 



surface, opposite to the drill-hole [h) on the other surface, until the needle was 

 exposed. Withdrawing the needle, I introduced a silver wire in its place, 

 and I had no difficulty, by means of forceps passed into the excavation made 

 by the gouge, in drawing out the wire. I was then able to pass it on through 

 the other drilled opening, and thus the two fragments were brought into 

 apposition. The ends of the wire were twisted together and left projecting 

 at the wound. Healing took place without suppuration or fever, and the 

 wire was removed on the 19th of May, seven weeks after the operation. The 

 wound made for its extraction soon healed, and the patient returned to 

 Glasgow ; and I afterwards had the satisfaction of learning that he was 

 wielding the hammer in an iron shipbuilding yard with his former energy. 



I have had two other cases of ununited fracture of the olecranon ; and, 

 as these are closely allied to the subject of my paper, I may refer briefly to 

 them. One was a man forty-five years of age, incapacitated for his occupation 



