In simple cases, the splints should be drawn close by straps and buckles; where the muscles are powerful, a roller should be wound round the splints instead of straps.
Fig. 35.—Fractured Shaft of the Humerus.
Step 4. A 2 inch wide roller is fastened to the arm above the elbow, and then carried round the trunk to the arm again, to steady the limb against the body.
Step 5. The hand and wrist are supported by a sling over the shoulders, the elbow being allowed to hang (see fig. 35).
This apparatus is worn three weeks, when the bandages are removed from the forearm, and the splints replaced less tightly than before. They may be substituted by a sheath of gutta-percha moulded to the arm from the acromion to the elbow, and buckled on to the limb. The arm must be supported by splints for five weeks, but passive motion of the elbow and wrist should be adopted after the third week. The wrist especially should be set at liberty as soon as possible. In treating this fracture great care is necessary that the bone be kept in accurate and close position, as the humerus is specially prone to remain un-united for many months.
Fracture of the Anatomical or Surgical Neck of the Humerus, of the Great Tuberosity, and of the Neck of the Scapula. These fractures are similarly treated.
Apparatus.—1. Paper for pattern.
2. Gutta-percha, leather, or millboard.
3. Pads. A soft thin pad, 10 inches long, 5 inches wide (a double fold of thick flannel or blanket answers very well), is wanted to line the axilla. If the cap is of leather or gutta-percha, a lining of wash-leather should be added after the splint is made.