_Fractures._--A bone may be broken at the part where it is struck (fracture from direct violence), or it may break in consequence of a strain applied to it (fracture from indirect violence), or the fracture may be due to muscular action as when a violent cough causes a rib to break. In the first case the fracture is generally transverse and in the second more or less oblique. The fully developed bone is broken fairly across; the soft bones of young people may simply be bent--_green stick_ or _willow fracture._ Fractures are either _simple_ or _compound_. A simple fracture is analogous to the subcutaneous laceration in the soft parts, and a compound one to an open wound in the soft parts. The wound of the soft parts in the compound fracture may be due either to the force which caused the fracture, as in the case of a cart-wheel going over a limb, first wounding the soft parts and then fracturing the bone, or to the sharp point of the fractured bone coming out through the skin. In either case there is a communication between the external air and injured bone, and the probability arises of the germs of suppuration finding their way to the seat of fracture. This greatly increases the risks of the case, for septic inflammation and suppuration may lead to delayed union, to death of large pieces of the bone (necrosis), and to osteomyelitis and to blood-poisoning. In the treatment of a fracture, every care should be taken to prevent any sharp fragment coming near the skin. Careless handling has often been the means of a simple fracture being converted into a compound one. In most cases of fracture _crepitus_ can be made out; this is the feeling elicited when two rough osseous surfaces are rubbed together. When a bone is merely bent there is, of course, no crepitus. It is also absent in fractures in which the broken extremities are driven into one another (impacted fracture). In order to get firm bony union it is necessary to secure accurate apposition of the fragments. Putting the broken ends together is termed "setting the fracture," and the needful amount of rest is obtained by the use of splints. As a rule, it is also advisable to fix with the splint the joint above or below the fracture. In cases in which a splintering of the bone into a joint has taken place, more especially in 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.