of the spine of from one to three
years; the _operative procedures introduced by Albe and Hibbs_ bring
about a bony ankylosis of the vertebrae in as many months, and may be
accepted as reducing the period of spinal immobilisation in the
recumbent posture to one year at the most.

The immobilisation of the recumbent spine in the attitude of
hyper-extension is most efficiently carried out by an apparatus on the
lines of the _Bradford frame_; this is made of gas-piping covered by
canvas, and is easily bent as may be required in the progress of the
case towards convalescence. The frame does not interfere with such
_extension_ as may be necessary, to the head, for example, in recent
cervical caries, or to the lower extremities where flexion at the hip
from spasmodic contraction of the psoas muscle may be efficiently
relieved by weight-extension.

_Gauvain's "wheel-barrow" splint_ and the _double Thomas' splint_
(Fig. 215) are efficient substitutes, but _Phelps' box_ has been
discarded because it fails to secure immobilisation of the spine.

When the stage of _convalescence_ is arrived at, and recumbency is no
longer essential, the child is allowed to sit up, stand, and go
about, with the restraint, however, of some apparatus that will
prevent movement of the spine, except to a limited extent. The
_plaster-of-Paris jacket_, applied over a woollen jersey, as
introduced by Sayre of New York, is probably the best; the jacket is
accurately moulded to the trunk while the child is partly suspended by
means of a tripod and the necessary strings under the chin, occiput,
and armpits. Poroplastic felt, celluloid, papier mache, and other
materials, reinforced by strips of metal, may be substituted for the
plaster of Paris. Various forms of _jury-masts_ and _collars_ have
been employed to diminish the weight of the head in children with
cervical caries, but have been very properly discarded as failing to
perform the function expected of them.

_Correction of the Angular Projection._--In cases in which the angular
projection or gibbus, as it is called by continental authors, is of
recent origin, it may be corrected by the method so successfully
employed by Calot of Berck-sur-Mer--a plaster jacket is accurately
moulded to the trunk, and a diamond-shaped window is cut in the jacket
opposite the gibbus; a series of layers of cotton-wool are then
applied, one on top of the other, so as to exert firm pressure on the
gibbus, a plaster or e