Generally speaking, nothing should be applied to the limb under the splint ex cept some elastic substance, such as cotton or wool,—the so-called carded wool makes the most comfortable (and expensive) dressing,—which will equalize the pressure of the splint and absorb the perspiration of the limb. In some cases, however, it may be deemed advisable to apply about the seat of fracture a number of coaptation splints: small thin pieces of wood, about an inch broad and some six inches long, wrapped in cotton, which, when bound about the limb at the seat of fracture, keep the bone-ends in apposition by direct pressure. But it must be borne in mind that they do not prevent angular deformity.
As a general rule, in applying splints the joints at the extremities of the fract ured bone should be immobilized.
If dressings are applied circularly to a limb they imperil its circulation and may give rise to gangrene if any swelling occurs in the limb subsequent to their application. Consequently they should not be used until the primary swelling has occurred, and, when used at any time, they should be frequently inspected.
Bony excrescences should be protected by padding about them, not on them.
Permanent wooden splints may be constructed after the fashion described above. Carved wooden splints are troublesome and expensive to obtain, and have no peculiar advantages.
Gooch's flexible wooden splint (Fig. 1) combines the advantages of lateral and coaptation splints. They are made by fastening a number of thin strips of wood side by side. Molded splints have almost certainly replaced them at the present day.
Fracture-boxes have been almost uni versally supplanted by more convenient apparatus. They are used only for fract ures of the leg and are essentially a com bination of a posterior splint with a mov able foot-piece and two lateral splints hinged to it. The fractured limb is placed on the posterior splint appropri ately padded, the padding folded over the splint, and the sides turned up. It may be suspended like a Hodgen or Smith splint with advantage. The heel is protected from pressure by the same device as serves in