For the completely efficient employment of massage and early movements, the proper position of the affected limb is a matter of much moment. In discussing the treatment of fractures from any point of view, it would at first sight seem superfluous to insist upon a cardinal point like the importance of posture. At the same time, it must be allowed that, obvious as the indications in this direction would naturally seem to be, it is not so commonly followed by practitioners as would be expected. It is, indeed, in the writer's experience not unusual to find this point entirely overlooked, and there is little doubt that many of the unsatisfactory results which are met with after fractures are due to the neglect of this rational indication. Pott's fracture may be taken for an example. How often are cases seen in which the injury is treated in the extended portion of the limb with all sorts of contrivances for the prevention of the not unusual deformity caused by the falling back of the foot with resulting elongation of the heel, a characteristic displacement in this injury, although it is not mentioned by Pott in his original description of the fracture; the obviously proper posture being semiflexion either in the manner described by Pott or by the use of that excellent apparatus, Neville's splint, or some similar contrivance. Again, how common it is to see ingenious but useless devices used for retaining in accurate position the fragments in a fracture above the knee, the limb being either nearly straight or at the most slightly flexed upon a double inclined plane; the ideal method being to place the limb in the flexed position, when the fragments almost naturally fall into good position. In all cases treated upon the lines of massage and early movements, care should be taken that the position of the limb is one in which the muscles which are likely to drag upon the fragments are in a state of the greatest rest - i.e. speaking generally, the position which is most comfortable to the patient. Further, in fractures of the upper end of the femur and of the humerus the indication is to bring the distal fragment in a line with the proximal one, and not by futile plans to endeavour to bring the proximal fragment into a straight line with the distal one.

Again, in making extension in such cases the fixed point should, when possible, be the knee or elbow, the trunk forming the extending weight.