n those cases in which tendons have been
injured, there may be a good deal of effusion into the joint and the
tendon sheaths, and this may be organized into fibrous tissue leading to
permanent stiffness. This is particularly apt to occur in old people.
Care must be taken in such instances by gentle exercises, and by passive
movement during the process of cure, to keep the joint and tendons free.
To take a common example,--in fracture close to the wrist joint, it is
necessary to arrange the splint so that the patient can move his fingers
and thumb, and the splint must be taken off every day, in order that the
wrist and fingers may be gently bent, straightened and exercised.

The treatment of fractures has undergone considerable improvement of
late years. Simple fractures are not kept so long at rest in splints,
but are constantly "taken down" in order that massage and movements of
the limb may be resorted to. This, of course, is done with the utmost
gentleness, and with the result that swelling, pain and other evidences
of the serious injury quickly disappear, whilst a more rapid and
complete recovery is ensured. Stiff hands and feet after fracture are
much less frequently met with. By the aid of the X-rays it is now easy
for the surgeon to assure himself that fractured surfaces have been well
adjusted and are in close apposition. But if they are not in a
satisfactory position, and it be found impracticable to assure their
close adjustment by ordinary methods, the surgeon now, without undue
loss of time, cuts down upon the broken ends and fixes them together by
a strong wire suture, which remains permanently in the tissues. If the
fracture be associated with an open wound of the part (compound
fracture), and the broken ends are found incapable of easy adjustment,
immediate wiring together of the fragments is now considered to be a
necessary part of the primary treatment. The French surgeon, Just
Lucas-Championniere, has done more than any one else to show the
advantage of discreet movements, of massage and of exercises in the
treatment of fractures.

_Special Fracture in Young People._--The long bones of children and
growing persons consist of a shaft with cartilaginous ends in which bone
is developed. As the result of injury, the end of the bone may become
detached, a variety of fracture known as _diastasis_. Such a
fracture--however well treated--may be followed by arrest of growth of
the bone or by stiffness of the n