OF THE REDUCTION, AND THE MEANS OF MAINTAINING IT.
37. The reduction does not differ from that of the radius (31), except in this, that the assistant who makes the extension, must place the hand in the opposite state, namely, that of abduction, in order that the fragments may be brought into contact, while the surgeon assists in this process, by pushing the broken ends of the bone in a direction opposite to that of their displacement.
As in the foregoing case, three splints are sufficient for the apparatus, where the radius, being unbroken, performs the office of a fourth.
The exercise of the limb, after the consolidation of the bone, is in general less necessary here, than in fractures of the radius (34), because the ulna, being an immoveable point of support for the motions of rotation, concurs in them only in a passive manner.
38. The ulna is surmounted, at its upper end, by a considerable appendix, curved before, where it corresponds to the articulation of the fore-arm, and is covered with cartilage; convex behind, where there is nothing to separate it from the external integuments, and is attached at its upper end to the strong tendon of the triceps muscle, which appears to be incorporated with it. This appendix resembles greatly, in its structure, form, and uses, the rotula, from which it would differ in nothing, if the inferior ligament of the latter were ossified, so as to form a bony continuity between it and the tibia. It is exposed to fractures, perfectly similar to those of the rotula, but which differs so essentially from the other fractures of the ulna, as to call for a separate examination.
39. The ancients appear to have had but little knowledge of fractures of the olecranon, respecting which they have transmitted nothing to us, unless with Dalechamps, we find cause to recognize a reference to this affection in the following passage of Paul of Egina: _Cubitus frangitur ... circa partem ad cubiti gilbum_.
Most of the moderns have spoken of it only in a vague manner; no one has described with accuracy the signs which characterize it; and few have given satisfactory ideas on its treatment. Petit has not spoken of it separately, and Duverney, who concludes with it his article respecting fractures of the fore-arm, has but imperfectly described for it a bandage which is in itself equally imperfect. Bell does not give us, on this point, an exposition of either his opinions or his practice.