Step 2. Reduce the fracture by gentle slow extension at the wrist; this being effected, apply the splints to the forearm, and let an assistant hold them while the bandage is rolled on.
Step 3. When a little wool has been wrapped round the hand and wrist, fasten the dorsal splint by figures of 8 carried round those parts; then draw the two splints together by simple spirals continued to the elbow (see fig. 31).
Fig. 31.—Fracture of both Bones of the Forearm.
Step 4. Support the forearm in a sling, to complete the apparatus.
The splints are worn three weeks; after this, passive motion may be practised daily, and the splints finally abandoned ten days later. But a sling is still required some ten days after the splints are laid aside.
When the ulna alone is broken, an anterior splint reaching from the inner condyle to the tips of the fingers often suffices without a second one.
When the shaft of the radius is broken high up (a rare accident) the displacement is sometimes very difficult of reduction unless the wrist be well supinated. To preserve this position it may be necessary to use a wooden angular splint, and to fix the vertical part to the arm behind the elbow, while the horizontal part is carried along the back of the forearm.
Fracture of the Olecranon.—This fracture, if seen early before effusion takes place, may be put up at once, but if delay till the joint is swollen has occurred, the limb must be kept quiet on a pillow, or on a splint in an easy position with evaporating lotions, until the effusion is absorbed, before any means can be taken to restore the position of the olecranon. Though the straight position of the elbow is usually employed, it is not essential for even very close union of the fragments.
In treating this fracture the following plan is useful.