A fracture of this kind may occur near the shoulder, the elbow, or midway between these points.

When the fragments are impacted - that is, crowded together by the force of the blow, the arm should be placed in an easy position and kept quiet. If the fragments are not attached or impacted, they should be set. The splint should be applied in such a way as to hold the fragments in place. The simplest method is that of Dr. Hamilton. The splint recommended by him may be made of pasteboard, felt, leather, or other material. Its form is shown in Fig. 372. It should be long enough to reach above the point of the shoulder. The edges of the notch in the upper end should be brought together by means of stitches, and while flexible the splints should be molded to the shape of the shoulder and arm, and allowed to become dry. Another short splint should be placed upon the inside of the arm. Each splint should be padded or covered with woolen cloth; it should then be secured to the arm by means of rollers, and the arm placed in a sling. It is well to bandage the arm before applying the splint, beginning at the fingers.

Fig. 372. Splint for Fracture of the Humerus.

Fig. 372. Splint for Fracture of the Humerus.

This method is applicable to fractures in the upper part of the arm. When the fracture occurs at the middle or lower part of the arm, a splint in the form of a right angle and of sufficient length to reach from the shoulder to the wrist should be employed for the inside of the arm, a short splint reaching from the shoulder to the elbow being placed upon the outside. After the fragments have been adjusted, the splints, properly padded, should be secured in place by proper bandages. When the elbow or other joints are much injured by the accident producing the fracture, the pain and inflammation should be subdued by the use of hot and cold applications before the splints are applied. When any of the nerves of the arm are injured so as to produce paralysis, the application of electricity should constitute a part of the treatment.