Another improvement made on the lower end of the external splint by Dr. James Hutchinson deserves also to be mentioned. It was found that in the original apparatus of Desault, the strap or roller L (plate 2) used for the purpose of extension, had a tendency to draw the foot too much outward. This fault Dr. Hutchinson very ingeniously remedied, by attaching to the lower part of the external splint, a little above the mortise, a small block extending inwardly, at a right angle with the splint, so far as to be on a line with the middle of the sole of the foot. Over the end of this block, in which a notch is cut to receive them, the ends of the strap L are carried, previously to their being secured to the external splint. By means of this expedient extension is made precisely in the direction of the limb, and the inconvenience of drawing the foot outward is completely obviated. Thus improved by Drs. Physick and Hutchinson, the apparatus of Desault for oblique fractures of the os femoris, leaves, perhaps, scarcely a remaining desideratum on the subject. ARTICLE III. EXPLANATION OF THE THIRD PLATE. This plate gives a full view of an apparatus for making permanent extension, in oblique fractures of the leg, when both bones are broken. This apparatus was first devised and constructed several years ago, by Dr. James Hutchinson, then a pupil in the Pennsylvania hospital, and is now in general use among the practitioners of Philadelphia. Fig. 1. Represents the leg and foot, with the apparatus applied. A. A common roller, passed several times round the leg a little below the knee, on which counter-extension is made. B. A silk handkerchief folded, or a strong roller made of soft muslin, passed once round the leg, just above the ancle, from behind forward. C. The place where its two ends cross each other to pass down along each side of the foot, as seen at _b_, to D, where they are secured by a knot drawn but moderately tight. _a a._ The same ends continued to E where they are again secured by a firm knot over the cross piece F, which passes between the two strong splints G G, that run on each side of the leg from a little above the knee, to the distance of four or five inches beyond the sole of the foot. This is the bandage by which extension is made, as will be mentioned hereafter. H. Two bits of strong tape, each about two feet long, placed in the longitudinal direction of the leg, and firmly secured by the roller A, which passes over their middle. Two such bits of tape, are thus applied on each side of the leg, and their four ends, passing through four holes in the upper end of each of the splints G G, are secured on their outsides by firm knots as represented at H. Fig. 2. A view of one of the splints G G, separated from the leg. _a._ The four holes in the upper end, through which the bits of tape H pass. _b._ The mortise in the lower end, which receives the cross-piece F.