In Fracture of the Pelvis, the fragments are kept in position by a broad roller carried several times round the pelvis and fastened.
THE UPPER EXTREMITY.
Fracture of the Metacarpal Bones.
Apparatus.—1. A piece of gutta-percha.
2. A roller 2 inches wide.
In treating this fracture it is important to keep the broken bone in place without confining the wrist or fingers.
A pattern of the palm and dorsum of the hand is cut out of paper, which is doubled round the radial side, letting the thumb out through a hole of convenient size to clear it (see fig. 27). The piece of paper is then laid on a sheet of gutta-percha ¼ inch thick, and the requisite quantity cut off; a hole as big as a pea is next punched in the gutta-percha in the middle, about 1 inch from the lower border, or at a point corresponding to the hole in the paper for the thumb. The fragments are then pushed into place and held so by an assistant, while the surgeon softens the gutta-percha in boiling water; when thoroughly soft, he draws the thumb through the little hole punched in the gutta-percha, and moulds the splint to the palm and back of the hand, bringing the ends of the gutta-percha together at the ulnar side of the hand; the fragments are held carefully in position till the splint is set. The splint is afterwards removed and trimmed. A few holes should be punched in it after it is moulded to allow perspiration to escape. The splint may then be covered with wash-leather, and a pair of straps with buckles stitched on to keep it in place. It is worn for three or four weeks, or until the fragments are united.
Fig. 27.—Gutta-percha Glove for fractured Metacarpal Bone.
Should gutta-percha not be at hand, another plan is effectual.