This section is from the book "The Home Hand-Book of Domestic Hygiene and Rational Medicine. Volume 2.", by J. H. Kellogg, M.D.. Also available from Amazon: The Home Hand-Book of Domestic Hygiene and Rational Medicine, Volume 2.
The limb should be restored at once as nearly as possible to a proper condition, and hot fomentations should be applied to relieve and prevent soreness and inflammation. As soon as possible, a surgeon should be called to set the limb. This is not generally nearly as painful an operation as commonly supposed, it being seldom necessary to apply any very great amount of force to get the parts into proper position. In case very great swelling has occurred before an opportunity is afforded to set the bones, hot fomentations or alternate hot and cold applications should be employed until the swelling and inflammation are reduced, before any attempt is made to set the broken bones.
The greatest difficulty against which a surgeon has to contend in the treatment of fractures is the contraction of the muscles, by means of which the fragments are drawn apart. This may generally be overcome by putting the limb in a condition in which the muscles will be as completely relaxed as possible.
In setting bones, the lower fragment is drawn firmly down, the upper one being held in position, or drawn in the opposite direction. This is always necessary to cause the ends of the bones to come together properly. It is generally necessary, however, to make some degree of pressure upon the sides in order to secure perfect adjustment of the parts. After the bone has been set, a proper splint or other apparatus should be applied in such a way as to keep the parte in position. In measuring limbs to see if they are of the same length, as should always be done, care should be taken to put both limbs in the same position, and to take measurements from the same points.
Compound fractures require very careful management, and with the best of care not infrequently result in considerable deformity.