88 Anatomy Applied to Medicine and Surgery. 



might blend the ulna and radius into one mass, thus pre- 

 venting supination or pronation of the hand. Another 

 objection to the use of the bandage next the skin is that 

 the swelling that always occurs after a fracture would 

 tend to cause constriction under the bandage, with the 

 possible production of gangrene from interference with 

 the circulation. It is in this fracture especially, that the 

 surgeon should be on his guard against the development of 

 gangrene. He should therefore inspect the limbs every 

 day until all danger of this complication be over, and' 

 should also employ proper dressings. The comparatively 

 superficial situation of the arteries of the forearm render 

 them liable to be compressed by improperly padded splints, 

 or by the employment of a graduated compress in the mid- 

 dle of the forearm for the purpose of separating the 

 bones. The splints should be just wide enough to prevent 

 the bandage from pressing on the ulnar or radial borders 

 of the forearm and thus crowd the bones together, and, as 

 mentioned above, the limb should be examined frequently, 

 removing the splints on each occasion sufficiently to note 

 the condition of the limb. Too much stress cannot be laid 

 upon this inspection since the relation of the arteries to 

 the bones is such, that a severe accident causing a break, 

 may at the same time injure the vessels sufficiently to 

 cause thrombosis, and, were the above precaution on the 

 part of the surgeon neglected, he might be held responsi- 

 ble. Amputation through the lower third of the forearm 

 is generally done by the circular method, whereas, in the 

 upper two-thirds, equal antero-posterior flaps are employ- 

 ed, since the outline of the limb in this part would prevent 

 the turning back of the flap of skin necessary in amputa- 

 tion by the circular method. 



