FRACTURE. 
“Fradures of the =“ can. hardly be difplaced in the 
longitudinal direction, account of the manner in which 
th of the ene are aes to the ulna by means of 
the ecko ous ligament. angement is commonly 
ef the tranfverfe ‘kind, which. ae cf an appremmnstion 
of the ends of the fracture to the ulna. 
in fraétures of the ar it is obferved, that the hand 
nin 
s Ona Surgery, p.18 
lus are to be tr 
r as fraGtures of both bones of the fore-arm. 
éndeavour muit be made to keep the ends of the bone from 
inclining too much towards the centre of the limb. The 
fore-arm fhould be put in the mid-ftate between pronation 
and fupination; and particular care ought always to 
taken-to employ an tae fplint of tufficient length to reach 
the fingers, keep the hand fteady, and hinder it from falling 
into the prone pofition. 
Fraétures of the Ulna. 
’ Fractures of this bone'are much lefs common than eee 
of the radius, and are generally produced by direét violence, 
that is to fay, b a blow, a kick, or a fall on the part. 
The radius, we bao: is often bro 
is applied immediately to the injur 
The lower end of the ulna is mott “Viable to be broken, 
becaufe itis the mott flender, and the leaft covered with 
F ies of the ulna are not apt to be fo materially dif- 
placed as thofe of the radius. The diagnofis is alfo not ‘fo 
plain as in the latter oe and indeed when the folation of 
continuity is towards the elbow, great attention is required 
to difcover what has happened. The furgeon fhould trace 
with his fingers the fuperficial parts of the bone, in order to 
find out whether there. is any irregularity, and he fhould 
prefs with his two thumbs above and below any fufpeéted 
point, for the purpofe of feeling a cre 
1€ upper So of the ulna is never “difplaced, the lower 
one alone can 
A very hittle extenfion ie generally requifite for the reduc- 
{ion of either a fraftured radius or ulna 
’' he treatment refembles whet ia been: adviled for Gales 
uy which the two bones are broken together. 
Fraéures of the Carpus, Metacarpus, Fingers, and Thumb. 
The fhape of the carpal bones, and the great quantity of 
cartilage which is placed around them, are circumftances 
rendering them little lable to ee broken, except by the cae 
of fire-arms, and by fuch external violence as crufhes the 
bones, as it were,-and does infinite mifchief to the foft 
a 
parte. 
“The metacarpal bones are alfo not frequently fractured ; 
ee ‘the accident is a now and then met with in prac 
roper than 
as atternpt to fave the limb. In other ae. the fore-atra 
and hand may be laid on a flat eee with a foft pad. 
The wound muft be drefled or. ed a ccording to cir- 
cumftances, and the limb kept Foes in a flin 
When any of the metacarpal bones are fractured, a cufhion 
or pad fhould be placed in the hollow of the palm of the hand 
and fingers. A roller is then to be applied from the fore- 
arm down over the wrift, the hand, ard the pad. . 
he: fingers are alfo liable to fr aes, Thefe cafes, under 
proper tre: reatment, generally terminate very shinies w ae 
out leaving behind the leaf j impairment of the Aft 
_ as acute 
oftene vineg ately enclofe the broken part 
atte e tape may then be applied for the arian a re- 
aining the paitebo t] oper 
geons next lay the hand and fingers ona flat fplint, and pit 
on a roller, fo as to keep the parts from moving. The for 
arm and hand fhould be put in a fling. 
r ten or twelve days, the applications fhould be taken 
off every day, and the finger bent and extended a certain 
anes a times, in order to prevent anchylofi ofis. 
end of ay weeks, the pafteboard, bandages, 
and fplint may be difu 
n regard to lee of the thumb, we need only remark, 
that they are very eafily mas and demand the fame 
treatment as fimilar injuries of the finger 
We have feen a fraCture of a stacarpl bone of the 
thumb. The accident occurred t gal who fell see 
ward with a load. ‘The hand was ne a finger-{plint 
which was put a tow-pad of fufficient fine to fill the holes 
of the palm. A piece of the emplaftrum faponis was put 
over the injured part, the limb was confined on the fplint 
with a common roller, and the fore-arm and hand kept at 
reft i ina fling. 
le cafe united very aia but the union was not 
firm before the end of. a month. 
Fractures of the Thigh-bone. 
The os femoris may be aia at any point, from its con» 
dyles below, to its round head above. However, experience 
evinces that ar the geste number of fractures happen 
to the middle third of the 
Fractures of the cisions ivided by writers into 
fimple and sale comminuted a complicated, tranf- 
verfe and oblique, 
It was an Se made by Petit, that the os acre 
was much lefs frequently eda into feveral pieces than other 
more f{uperficial bones. may alfo remark ee 
fraGtures of ee thigh, like comminuted ones, are by no 
means comm: 
Suu tranfverfe ‘and oblique dire€tions of the em of 
conti are erence 
in fg of difficulty attending the t ae as the 
reader wih peas underftand. ‘TTranfverfe fra€tures are ~ 
by far the via troublefome to unite, without any deformit ty 
being oeccafion 
e fy ana and changes produced in the limb by a 
fr adie of the thigh-bone, are of the following oT 
A very fevere pain in the fituation of the injur atly ex- 
* ee when the mufcles are feized with violent: ae 
ry singed or when the member is at all moved by the 
urgeon. Such pain is no. doubt excited by the manner in 
which the rough, tars ends of the fracture muft irritate and 
i the. furrounding foft parts.- The praCtitioner may 
. 
; bringing the extremities of 
{ 
the fracture i into EO and then mers them. He alfo 
