Fig. 29.—Fracture of the Radius.
Step 3. Raise the straight part of the outside splint till parallel to the forearm, thus adducting the hand to the ulnar side; and fix the splint by a strap of plaster an inch wide carried round it and the forearm below the elbow.
Step 4. Apply the inside straight splint next, keeping the front of the carpus and of the lower fragment exposed. Draw the two splints together by simple spiral turns of a roller, begun just below the elbow and carried down to the lower end of the inside splint, there fasten it off.
Step 5. Put a narrow sling under the forearm between the elbow and the wrist to support the limb comfortably.
When the apparatus is finished the position of the broken fragments should be visible (see fig. 29) and not concealed by bandage. The hand should also be quite free of the sling, lest it be drawn from its proper adducted position. The fragments are in good position when the hollow on the anterior aspect of the wrist and the prominence on the corresponding posterior surface are removed.
The Gutta-percha Gauntlet is another plan of treating fracture of the lower end of the radius that may often be adopted from the first, and may always replace the wooden splints and bandage when the swelling has subsided. It was contrived by Mr. Heather Bigg, and permits the patient to use his hand to some extent while the bone is uniting.
Apparatus.—1. A piece of gutta-percha ¼ inch thick, wide enough to enwrap the metacarpus and wrist, and long enough to reach up the lower half of the forearm. Two thirds across the width, and about 1 inch from the lower end, a small round hole is punched. The sheet is then softened in hot water, and applied to the hand, the thumb being thrust through the hole punched to receive it, which rapidly enlarges when soft. The gutta-percha is then adjusted to the hand and forearm, its borders meeting at the ulnar side of the limb, rather nearer the inner border of the arm than is depicted in fig. 30.
Fig. 30.—Gutta-percha Gauntlet for Colles’ Fracture.