Kitap 8
10
The foregoing treatment is general, the following applies to particular fractures. If the upper arm is fractured, extension is not made as in other limbs, but the patient is seated on a high stool, whilst the surgeon faces him on a lower one. One bandage about the patient's neck is to serve as a sling to support the forearm; another is looped under the armpit and is knotted over the head; a third surrounding the lower end of the humerus is carried down and has its ends tied together below. Then an assistant behind the patient stretches out his right forearm through the second loop, if it is the patient's right humerus which is to be extended, his left if it is the left, and grasps a stick placed upright between the patient's thighs. At the same time the surgeon puts his right foot in the third loop I have described, if the left arm is being treated, his left foot if the right. And at the same time the assistant lifts one loop up while the surgeon presses the other down, the result being that the humerus is gently extended. Now the bandages, if the middle or lower part of the bone is broken, are shorter, but longer for the upper part, so that they may stretch thence under the opposite armpit too, over the chest and blade-bones. And they . . . But from the first the forearm during the bandaging must be flexed thus, and, since it must be put so even before the bandaging, this ensures that it cannot later, when in the sling, bend the upper arm from the position in which it was while being bandaged. And when the forearm is in a sling, the upper arm too is to be loosely bandaged to the side; this causes is to be moved as little as possible, and so the bones keep in the position in which they have been set. When it is the time for applying the splints, the longest should be placed externally, shorter ones over the biceps in front, the shortest under the armpit. And when the fracture is near the elbow joint, the bandage must be taken off more frequently, or the sinews will become fixed, and the forearm rendered useless. Whenever the bandages are removed, the site of the fracture should be held by the hand, the elbow fomented with warm water, and rubbed with liquid cerate. The splints should not be applied at all over the bony points of the elbow, or should be somewhat shorter.