262 The Humerus 



treated by flexing and pronating the fore-arm, so as to take all strain 

 from the loosened piece of bone. 



The external condyle is not so likely to be detached as the internal, 

 as it joins the shaft earlier, and is not so prominent nor so much exposed 

 to injury. This fracture is likely to pass into the joint ; and in such a 

 case the elbow had better be put at a right angle and secured in a 

 moulded splint, in case of ankylosis occurring. 



Non-union after fracture of the shaft of the humerus is specially 

 liable to occur unless the muscles which may move the fragments be 

 preserved in absolute rest. For this purpose the fractured shaft should 

 be fixed by an angular splint extending from shoulder to hand (so as 

 to keep the fore-arm quiet), whilst short splints should be secured 

 around the seat of fracture. 



THE BRACHIAL ARTERY 



The brachial artery is the continuation of the axillary, and, be- 

 ginning at the lower border of the tendon of the teres major, extends 

 along the inner and anterior aspects of the humerus to end opposite 

 the neck of the radius by dividing into radial and ulnar. 



Its course may be marked out by a line drawn from beneath the 

 anterior axillary fold along the furrow on the inner side of the biceps 

 to the middle of the bend of the elbow. 



Compression. In its upper part the artery may be compressed 

 by dragging it outwards, against the bone, near the insertion of the 

 coraco-brachialis ; in the lower part it must be thrust backwards 

 towards the humerus, where the brachialis anticus is covering the bone. 



Compression just above the elbow may be effected by forcibly 

 flexing the fore-arm. The mass of the muscles of the upper part of 

 the fore-arm then squeezes the vessel against the firm bed of the 

 brachialis anticus. (See how your own radial pulse is stopped in 

 energetic flexion of the elbow.) This is a useful method of treatment 

 in aneurysm in that neighbourhood, as well as a temporary measure 

 in the case of severe haemorrhage from a wound in the palm. 



Relations. Over the artery are skin, superficial fascia, the basilic 

 vein (which runs parallel with the artery), and, at the elbow, the 

 median basilic vein ; the deep fascia, and, between the artery and 

 the median basilic vein, the bicipital fascia ; the inner border of the 

 biceps, which overhangs the artery, and the median nerve which 

 crosses the middle of its course. 



Behind are the insertion of the coraco-brachialis, the long and 

 inner heads of triceps, and the brachialis anticus ; and high up is the 

 musculo-spiral nerve turning inwards and backwards away from the 

 vessel. To the outer side are the shaft of the humerus, the coraco- 

 brachialis and biceps, and the median nerve in the upper part. To the 

 inner side are the internal cutaneous and ulnar nerves, and the median 



