Le traitement des fractures des os ..L'assistant parfait demeure qui tient les bras doit avoir rien d'autre à faire.Avant d'appliquer le plâtre de Paris l'attelle il est souvent conseillé d'attelles coaptation mince toapply au siège de fracture pour donner plus de force à l'international d'une attelle. Avec ces attelles coaptation inuse un plâtre plus léger d'une attelle peut être appliqué sans sacrificingstrength. Une étroite bande de coton sur le corps et l'armshould la constante membre supérieur. Le poignet doit être sup-porté par une élingue cravat. L'après-soin d'une affaire traitée par l'éclisse de plâtre sera 152 FRACTURES O

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The treatment of fractures . of the bones remains perfect.The assistant who holds the arm should have nothing else to do.Before applying the plaster-of-Paris splint it is often advisable toapply thin coaptation splints at the seat of fracture to give addi-tional strength to the splint. With these coaptation splints inuse a lighter plaster splint may be applied without sacrificingstrength. A narrow cotton swathe about the body and armshould steady the upper extremity. The wrist should be sup-ported by a cravat sling. The after-care of a case treated by the plaster splint will be 152 FRACTURES OF THE HUMERUS similar to that following any other treatment after union hasoccurred. The plaster may be left in situ for four weeks ; then, ordinarily, repair will be found so far advanced that the plastersplint may be dispensed with and the ordinary coaptation splintsand swathe may be used. If the plaster splint has proved com-fortable, it may be split and reapplied. Massage and Passive Motion : In view of the possibility of. Fig. 182.—Case: Fracture of tlie shalt of the left humerus. Fracture united. Note atrophyof upper arm, including deltoid. Loss of muscular contour very apparent. nonunion of this fracture, it will be wise not to begin massageuntil union has begun. Passive motion to the shoulder andelbow should be gently made at as early a date as possible, withdue consideration to the condition of repair in the fracture. Ifat the end of three weeks union is found to have begun, it willbe wise to move the shoulder and elbow gently by passivemotion. The seat of fracture should be cautiously guardedagainst movement during these gentle manipulations. A little MUSCULOSPIRAL NERVE INVOLVEMENT I 53 gentle passive movement of this sort repeated occasionally dur-ing the process of repair will assist very considerably in therestoration of the functional usefulness of the shoulder and elbow, which so often become stiff from immobilization. Prognosis.—Ordinarily, union occurs readi

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