59. Sprains and Dislocations. A twist or strain of the ligaments and soft parts about a joint is known as a sprain, and may result from a great variety of accidents. When a person falls, the foot is frequently caught under him, and the twist comes upon the ligaments and tissues of the ankle. The ligaments cannot stretch, and so have to endure the wrench upon the joint. The result is a sprained ankle. Next to the ankle, a sprain of the wrist is most common. A person tries, by throwing out his hand, to save himself from a fall, and the weight of the body brings the strain upon the firmly fixed wrist. As a result of a sprain, the ligaments may be wrenched or torn, and even a piece of an adjacent bone may be torn off; the soft parts about the injured joint are bruised, and the neighboring muscles put to a severe stretch. A sprain may be a slight affair, needing only a brief rest, or it may be severe and painful enough to call for the most skillful treatment by a surgeon. Lack of proper care in severe sprains often results in permanent lameness. A fall or a blow may bring such a sudden wrench or twist upon the ligaments as to force a bone out of place. This displacement is known as a dislocation. A child may trip or fall during play and put his elbow out of joint. A fall from horseback, a carriage, or a bicycle may result in a dislocation of the shoulder joint. In playing baseball a swift ball often knocks a finger out of joint. A dislocation must be reduced at once. Any delay or carelessness may make a serious and painful affair of it, as the torn and bruised parts rapidly swell and become extremely sensitive. 60. Broken Bones. The bones, especially those of the upper limbs, are often fractured or broken. The _simple_ fracture is the most common form, the bone being broken in a single place with no opening through the skin. When properly adjusted, the bone heals rapidly. Sometimes bones are crushed into a number of fragments; this is a _comminuted_ fracture. When, besides the break, there is an opening through the soft parts and surface of the body, we have a _compound_ fracture. This is a serious injury, and calls for the best surgical treatment. A bone may be bent, or only partly broken, or split. This is called “a green-stick fracture,” from its resemblance to a half-broken green stick. This fracture is more common in the bones of children. Fractures may be caused by direct violence, as when a bone is broken at a certain point by some powerful force, as a blow from a baseball bat or a fall from a horse. Again, a bone may be broken by indirect violence, as when a person being about to fall, throws out his hand to save himself. The force of the fall on the hand often breaks the wrist, by which is meant the fracture of the lower end of the radius, often known as the “silver-fork fracture.” This accident is common in winter from a fall or slip on the ice.