Stiffness of joints after sprains is almost always due to the prolonged use of splints or delay in the commencement of voluntary and passive movements. Stiffness of this kind can be nearly always avoided by the removal of splints, if their use is considered necessary, once daily for an hour or so, during which the patient is encouraged to move the part as much as the pain will allow. It appears that one of the main reasons for the prolonged use of splints in sprains of joints is the fear of tubercle, but in the absence of persistent local heat it is hardly needful to say that the fear of tubercle is entirely unnecessary.

Recently I have seen a case in which, in conse-quence of acute effusion into the knee-joint after sprain, the part was immobilised in splints for six months, with the result that a bony ankylosis followed. Nothing can be more harmful in sprain of joints than the too prolonged use of splints. Personally, in sprains - the existence of fracture having been excluded by the use of the x-rays - I have long since given up the use of splints altogether.