Fracture of the cubit. - The cubit hath two bones, viz. the radius and ulna. Fractures in these are discovered by the sight, touch, and ear: by the touch and sight, if the hand of the affected cubit be moved inward and outward, though a fractured ulna, from its inability to support the joint, will be discovered sooner than that of the radius: the ear discovers a grating noise if the elbow be held steady, and the hand moved inward and outward.

If the radius is to be reduced, and the fragments have receded towards the ulna, an assistant should stretch the arm, and the surgeon should press down the patient's hand towards the ulna, until the depressed part is elevated. The arm on each side must then be compressed with the palms of the hands, so as to restore the compressed muscle between the ulna and radius, and the fragments of the radius to their natural position. A compress and strong pasteboard upon the fore part of the arm, over the quadratus muscle, will prevent it from drawing the fractured bone toward the sound one. The circular bandage must be applied, and the arm suspended in a sling, with the hand in a prone situation.

If the ulna is fractured, the same directions should be followed: remembering to turn the hand towards the radius, until the depressed part of the ulna has recovered its former position.

If both these bones are broken, we must still proceed as before. Mr. Pott observes, in this case, that it is necessary to put the longitudinal compresses as nearly as possible between the bones, in order to prevent the callus uniting them, which would hinder the rotatory motion of the arm.

It often happens in fractures of this part, that, notwithstanding every precaution, a stiff* joint follows; therefore, though, in this particular instance, and in fractures of the patella, keeping the whole limb straight relaxes the particular muscles of the bones, yet if a stiff joint is apprehended, as soon as the benefits from relaxation have ceased, the limb should be gently bent; fora stiff bent cubit is much more useful than a straight one. See London Medical Journal, vol. i. p. 356; Edinburgh Medical Commentaries, vol. ix. p. 582; White's Surgery, b. iv.; Bell's Surgery, vol. vi. p. 84.

A fractured finger. - When the contusion of the hand or fingers is very considerable, amputation is most advisable; but if the part can be saved, the-fractured bone must be properly placed, the fragments reduced, and the whole confined with a narrow fillet to the next finger. Begin the bandage about the wrist, cany it over the back of the hand to the finger; and, if more fingers than one are fractured, carry it round each separately, and then round them all: put a ball into the hand, and bind it tight to the fingers; continue the roller back to the wrist, and place the hand in a sling. Bell's Surgery, vol. vi. p. 93.; White's Surgery, p.

A fracture of the thigh. - Hippocrates justly observes, that when either the bone of the humerus or of the thigh breaks inwardly, the symptoms are more dangerous than when the same happens outwardly, because the vessels and nerves are lodged in the inner parts.

When the thigh is fractured in its middle or lower part, it may be reduced by the hand; but when the accident happens on the upper part, greater force is required. Wherever the seat of the fracture is, the position of the patient, and of the limb to be reduced, should be ordered as in the case of a fractured leg. When a due extension is made, and the ends of the fractured bone replaced, splints, properly padded with tow, must be secured; and if Gooch's machine for fractures of the thigh bone is used, patience only will be further necessary. If this machine is not to be procured, the position proposed, when the leg is fractured, may be trusted, and particularly whan the neck of the thigh bone is the seat of the disorder.

When a fracture of the thigh is complicated with a wound, it is dangerous, and sometimes incurable. When near the joint it is usually fatal, as the large blood vessels are frequently lacerated. The danger is not much less if the wound is on the back part of the thigh, because of the difficulty in dressing it. If the haemorrhage can be restrained by using the tourniquet, and taking up the wounded vessel, the fracture may be reduced; but if the bone is much injured, and the haemorrhage violent, amputation is usually most eligible.

A fracture of the neck of the thigh bone is sometimes mistaken for luxation; but it is more easy to break than to luxate this bone, and fractures in the neck are more frequent than in its other parts. A fracture of this kind is reduced and retained with more difficulty than in the body, and a lameness usually follows the reunion. The oblique direction of the neck, with the number and strength of the muscles, occasion these difficulties.

When this fracture happens, according to Gooch, the thigh and knee are turned outwards; the limb is much shortened, and considerably shrunk; pain is felt in the course of the sartorius muscle, which, from its origin and insertion, must be greatly stretched, often causing pain on the inside just below the knee; and a crepitus is observed when the patient moves his limb. When these symptoms appear, the limb being gently but steadily extended, until the fractured limb appears as long as the sound one, let the patient be laid in the posture recommended when the leg is the part thus affected, and let bleeding be employed to prevent or remove inflammation. If Gooch's extending machine could be obtained, its use would be the most eligible method for preventing future inconveniences. Bell's Surgery, vol. vi.p. 95.; White's Surgery, p. 146.

A fractured humerus. - If this bone isfractured in the .middle, no great difficulty attends: but if near the superior and anterior head, both pain and danger follow. To reduce this fracture, place the patient in a chair; his elbow being bent, let an assistant steadily grasp the frartured bone at its lower end, while another assistant does the same a little below the shoulder; then the arm being extended gently, the operator lakes the fractured part in his hand; and as soon as the extension is sufficient, the bone being replaced, he applies the bandage, and confines it by hanging the fore arm in a sling.